Medical schools should devote more time to teaching students about care coordination, population health, and electronic health records so that students will be ready to be a part of the patient-centered medical home, according to a new report from four groups representing primary care physicians.
In a joint principles document, the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, and American Osteopathic Association outlined how all medical schools can provide students with a foundation in the elements of the medical home, regardless of whether they plan to pursue a career in primary care.
The groups recommend that students learn about the principles of the medical home, such as being a personal physician, leading a team of providers, providing care for the “whole person,” coordinating care across the health care system, improving the quality and safety of care, and providing enhanced access.
For example, as part of the principle of whole-person orientation, the groups recommend that medical students practice motivational interviewing as way of encouraging behavioral change. They also recommend that students work with health coaches who care for patients with complex conditions.
In learning about care coordination, the groups call for students to become familiar with electronic health records, e-visits, and electronic billing; learn to access online medical information; and use health information technology in their own continuing education.
The report also recommends that medical schools teach physician payment methodologies and current trends in health care costs.
While medical schools today teach some elements of the medical home model, such as the continuum of care, there's not a focus on the medical home itself, said Dr. O. Marion Burton, president of the AAP and associate dean for clinical affairs at the University of South Carolina, Columbia.
He said that he expects medical schools to embrace the recommendations for teaching the medical home, but that it will take 3–4 years for most institutions to do so. The first step, which could take a year or more, will be to recruit new faculty members with experience with the medical home concepts. The next step will be to determine exactly how to teach the model, whether through lectures or more hands-on training, or some combination of approaches. And it may take another year to integrate the subject matter into the existing curriculum, he said.
The major sticking point may simply be finding the time in an already packed curriculum, said Dr. Michael S. Barr, an ACP senior vice president. The challenge for medical school officials, he said in an interview, will be figuring out what to take out of the current curriculum while still ensuring that physicians are prepared to enter residency training.