Dr. Paul George is an Assistant Professor of Family Medicine at the Warren Alpert Medical School of Brown University (AMS). He’s also the Director of AMS’ Primary Care-Population Medicine Program, a new combined MD-ScM program in which students earn a medical degree and a Master’s of Science degree in Population Medicine.
We first met Dr. George when he signed on as a Celebrity Judge for Medstro’s Primary Care Challenge (#PCC14) – if you’re doing something innovative in primary care, be sure to submit and share your ideas.
We were incredibly impressed with Dr. George’s Primary Care-Population Medicine Program, the first of its kind in the United States. The program prepares medical students for leadership roles in healthcare local, state, and national levels in areas ranging from primary care clinical service to research, education, and health policy – encouraging collaborative care, which is the basis of population medicine. Dr. George shared his thoughts about primary care and the future of our healthcare system in a recent interview.
Some people argue that an appreciation for primary care starts in medical school. Do you think this is true?
Studies suggest that interest in and an appreciation for primary care starts before medical school. We know that students with more life experience, for example, participation in the Peace Corps or Teach for America, are more likely to go into primary care. Students who go to post-baccalaureate programs, who are typically older, are more likely to go into primary care. Students who come from rural backgrounds are also more likely to go into primary care. So there are definitely groups we can target early on to increase interest in primary care prior to medical school. That being said, we also need to promote primary care when students arrive in medical school. We need early and repeated exposure to primary care physicians, not just in doctoring-type courses, but in a spectrum of courses, including the basic sciences.
How is medical education different now than it was 10 years ago?
Medical education is very different than it was 10 years ago. We are “flipping the classroom” more – delivering knowledge at home through online lectures and readings, and asking students to apply that knowledge in the classroom through practical exercises. We are teaching students to work in inter-professional teams, collaborating with nurses, pharmacists, social workers and other health professionals, so that working in teams is natural when students become residents and attendings. We are including health policy education more frequently in the curriculum. We are using different curriculum models for clerkships, such as the Longitudinal Integrated Clerkship model, in which students do all of their clerkships concurrently, promoting continuity with patients, mentors and communities instead of traditional block schedules. It is an exciting time for medical education!
Some people say that America has to fully embrace population medicine because we’re all paying for it anyway (it’s where 1/6 of our country’s expenditures go, and we see it in our taxes and expensive medical plans, too). So… are we embracing population medicine?
As a nation, yes. We are embracing population medicine more and more. The days of physicians working in silos as independent practitioners is slowly coming to an end, to be replaced by team-based care in which health professionals work together to promote the health of a practice and community. Many practices are already adapting to these changes – they are hiring pharmacists to help manage medications, nurse care managers to ensure a smooth transition between health care settings (such as inpatient and outpatient) and behavioral health specialists because so much of primary care especially is behavioral health.
Physicians are also training in clinical informatics to become experts at analyzing data and acting on that data to improve the health of a population. We are instituting patient-centered medical homes and neighborhoods. And payers are taking notice – physicians are being paid for the quality of care they provide.
Is population medicine the future of American healthcare?
I believe that the future of American healthcare is in health professionals working together with other key stakeholders (such as government and insurers) to meet the triple aim of improving quality, improving patient satisfaction and decreasing cost. So yes, population medicine is where we’re headed.
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