In a recent interview, physician and noted social activist Dr. Paul Farmer gave this advice to graduating medical professionals: their real impact will come when they work in teams. As the co-founder of Partners in Health and a champion of improving health in underserved communities, Farmer’s work is built on building partnerships and applying successes and lessons learned to new frameworks.
Farmer’s big idea message is alluring in its simplicity, which is what makes it such an important one. After all, collaboration, particularly in terms of community-based health care and in managing chronic diseases across specialties, is something we struggle with in this country. By 2025, an estimated 164 million Americans are expected to live with at least one chronic condition, so coordinated care that utilizes appropriate technology and minimizes complications and disease progression is critical.
Earlier this year, the American Medical Association launched the $10 million “Accelerating Change in Medical Education” initiative. The premise of the initiative is to help facilitate “bold structural change” at each selected school. Ideally, the proposed innovations will support a significant redesign of undergraduate medical education to improve health outcomes and reduce cost, align education and training with the evolving nature of 21st century health care, and encourage physician satisfaction and more sustainable payment and delivery methods. Over the next five years, the AMA will give $2 million annually to support eight to 12 medical education innovations.
Substantive systemic change is hard to come by, and the AMA’s program is a good step. However, as a patient who has lived with multiple chronic illnesses for 33 years, I’d like to add another perspective on teamwork for medical schools to consider as they look to redesign medical education: the importance of collaboration within the patient-provider relationship.
Want to see improved health outcomes? Have engaged, informed patients who are true partners in their health care and medical decision-making. Future physicians need to see patients as the valuable resource they are, recognize the ways we’re sharing health information, and know what that information looks like. We don’t necessarily need our doctors and nurses to be on Twitter, for example, (though some do this exceptionally well) but we do need emerging health professionals to recognize the ways in which patients can harness technology and health information to best take control of our health.
According to the Society for Participatory Medicine, 90 percent of health care takes place outside the doctor’s office. Increasingly, these interactions take place virtually. Patients are not just Googling symptoms or printing articles; we’re sharing treatment information with each other in robust online patient communities. Many of us with chronic and rare diseases are using social media platforms and patient networks to participate in and encourage enrollment in clinical trials. Those of us with the digital literacy and resources to do so are tracking and sharing data with smartphones, and bringing this information to our physicians.
The sheer availability of health information accessible to us doesn’t necessarily mean it is credible or reliable. We need practitioners who can counsel us on how to be discerning readers of what we come across, to assist us as we wade through the snake-oil cures and the potential conflicts of interest, and who can help us put newly published research into context with what it mean for us as individuals.
We hear the term transparency so often these days, and true collaboration hinges upon it. Transparency reaches across both sides of the desk, from the funding of research articles, direct-to-consumer advertising of drugs, and costs of medical procedures and interventions to patients’ disclosure of alternative treatments they may be trying or have questions about, for example.
When dealing with a serious health issue, 70 percent of adults in a Pew Research Center’s Internet and American Life Project survey consulted health professionals. When it comes to the emotional aspects of living with disease, patients increasingly turn to each other for support and advice, too. If partnership can bring together the expertise of medical professionals with the insights of patients, who know their own bodies and symptoms better than anyone else, then we will have the right framework for improved health outcomes.