Soapbox

Kaiser’s medical school offers opportunity to change medical education

Kaiser Permanente recently announced plans to open a medical school in 2019. Kaiser’s move into medical education has the potential to transform the way doctors are trained in an evolving health care landscape.

The modern medical curriculum was developed in 1910 after the publication of the Flexner Report – an independent review that found nearly all U.S. medical schools lacked rigor. While the changes introduced were revolutionary for their time, the approach to medical education has undergone little change in the subsequent 100-plus years.

Medical schools today focus on teaching students about the scientific nature of disease. Academic medical centers place a tremendous emphasis on research and try to instill a sense of curiosity about biomedical processes.

However, health care has changed dramatically in the past century; it would be a stretch to claim that a health care “system” even existed in 1910. Yet today’s doctors exit school with little understanding of costs, how to leverage new technology, and how to navigate a complex regulatory environment.

Kaiser has an unprecedented opportunity to introduce a paradigm of medical education that addresses these issues. Obviously new medical schools have opened in the last century, including several in the past few years. Some have experimented with curricular changes, but few have made a lasting impact. What makes Kaiser different is that it comes with the scale and resources of a $56 billion health care provider.

Moreover, aspiring doctors must consider how their school will influence their ability to obtain a residency and eventually a job. Most schools cannot be too innovative because they risk endangering their students’ prospects if they deviate from accepted norms.

Kaiser, on the other hand, offers its own residencies and employs thousands of physicians. It can therefore create a pipeline that will help attract and train students for modern medical practice.

The question then is how to take advantage of the opportunity. First, Kaiser should mandate substantive business and leadership education.

Medical schools typically have cursory teaching on issues surrounding cost, access and leadership, leaving doctors poorly prepared for challenges they face on a daily basis. For instance, they often do not know the costs of treatment. As a result, physicians may not be able to advise patients on critical health decisions that involve money.

Kaiser is well-suited to introduce students to these concepts through applications in real-world scenarios. Leadership training can also prepare students to work in the context of a medical team that includes nurses, pharmacists and others. While not medical, such skills allow doctors to provide better patient care.

Second, the school should build digital health training into the curriculum. Medical schools provide little exposure to technology-enabled health care even as it becomes an increasingly important aspect of medicine. Kaiser hospitals and clinics use telemedicine extensively and can provide that experience to students.

Finally, Kaiser should encourage students to pursue nonclinical interests during school. Many training programs require students to conduct research. While understandable given that research is the currency of academia, this prioritization sometimes precludes students from pursuing other interests.

As a nonacademic hospital system, Kaiser can push students to explore other facets of health care in an applied setting, whether their interest is management, policy, technology or something else. Physicians’ role in medicine includes more than science. Kaiser is uniquely positioned to prepare students for that role.

Kaiser redefined health care once with an emphasis on value rather than volume-based care, and built a model that health systems across the country have sought to replicate. With the right approach to a new school, Kaiser may be able to do the same for medical education.

Akhilesh Pathipati is a Stanford medical student and Harvard graduate who has worked on health initiatives in Massachusetts and California. He is a Sacramento native.

  Comments