Alpert Medical School of Brown University is introducing a program meant to teach primary care doctors to think beyond the care of individual patients. The school is planning a dual degree program, to begin in 2015, in which doctors in training can earn a master’s degree in population health.
The program will enroll 24 people per class who plan to work in primary care, and the curriculum will include disease prevention and the needs of certain patient groups, such as newborns and new mothers or the elderly, said Dr. Edward Wing, dean of medicine and biological sciences. It will emphasize teamwork across medical disciplines and cover new health care delivery models, such as patient-centered medical homes.
Primary care doctors are playing a central role in the planned overhaul of the US health care system and coordinating patient care across many specialties. They also are under pressure to address factors affecting the overall health of the communities they serve and to provide more preventive care.
For example, Wing said, primary care physicians need to look at the individual and the systemic causes of obesity among their patients. “How do you actually address that?” he said. “The medical system simply hasn’t done it very well.”
As health care changes fast, those who train medical professionals are pushing to keep up. Many are tweaking programs and introducing new ones to help health care leaders to be as prepared as possible for the changes.
Dartmouth College this month graduated the first class from its master’s program in Health Care Delivery Science, a partial distance learning program that combines class time and hands-on projects meant for people already in leadership positions in health care. David Sell of The Philadelphia Inquirer described the program this way when it got started in 2011:
The first class of 47 people, from 17 states and two foreign countries, includes doctors, nurses, chief financial officers, consultants, foundation employees, military members, insurers, government planners, and health-systems leaders. Many applied as groups. Oklahoma State Sen. Tom Adelson is paying his own way but working with people from a Tulsa hospital that gets many low-income patients with chronic problems such as diabetes, heart disease, and asthma—problems seen in many U.S. cities including Philadelphia. The youngest student is 37, and most have spent at least 20 years in health care.
“We were trying to attract a student body that was in the real world,” said Al Mulley, director of the Dartmouth Institute for Health Care Delivery Science, who has spent 30-plus years as a doctor and teacher in Boston hospitals and at Harvard. “We weren’t sure we wanted people who could afford to take two years off or whose organizations could afford to send them away for two years. Our argument to CEOs was that this really will be unique.”
Wing said the Brown program may be the first of its kind in the country to integrate population health into a four-year medical school in this way. The program will include a clerkship program modeled after one that was piloted by Cambridge Health Alliance, in which students work with a primary care physician to follow a group of patients with varied needs over time. In a traditional model, students instead rotate among specialties, such as obstetrics, surgery, and pediatrics.
“We really have to reimagine our medical education,” he said.