Does medical education prepare docs for team-based care?

Though new models of healthcare delivery increasingly focus on collaboration, medical education still does not adequately teach aspiring doctors how to work effectively with a team of caregivers, writes Dhruv Khullar, M.D., in a post for the New York Times' Well blog.

Until they start residency, medical students neither study nor work with nurses, physician assistants, social workers or other non-physician professionals, according to Khullar, who is a resident at Massachusetts General Hospital and Harvard Medical School. Young doctors also aren't taught how to understand their fellow clinicians' roles and limitations.

This siloed approach to medical education no longer makes sense given the industry's accelerated shift toward value-based payment models that encourage team-based care, Khullar argues, adding that this is especially true in light of the Department of Health and Human Services' announcement that it will shift 30 percent of Medicare payments to alternative payment models by 2018.

A recent report from the Institute of Medicine echoes Khullar's concerns, as it found that there currently are no learning models that factor in all of the features necessary to measure the link between health outcomes and interprofessional education, FierceHealthcare has reported.

Some notable exceptions to the paucity of team-based learning, however, include the National Center for Interprofessional Practice and Education, backed in part by the Robert Wood Johnson Foundation, and the Retooling for Quality and Safety initiative, led by the Josiah Macy Jr. Foundation and Institute for Healthcare Improvement. The latter awards grants to universities to support patient-safety focused interprofessional learning models, according to the post.

Initiatives like these not only are more important than ever in an era of value-based care, but it's also key to start such interprofessional training as early as possible and to focus especially on doctors, who research suggests need the most help learning how to collaborate effectively, according to Khullar. "Team-based care forms the foundation of novel payment models and a higher-value health care system--and the training of new health professionals must reflect the evolving practice environment in which they find themselves," he writes.

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