Addressing Issues

Professional Training: Preparing Health Care Professionals for Systems Change

Background

Undergraduate, graduate, and continuing education programs for physicians, nurses, and other health care professionals need to prepare health care providers to be effective participants in a new health care system. Traditionally, "nothing about medical school prepares a physician to take a leadership role with regard to changes in the system of care."1 The focus of medical school has been understanding human biology, the pathophysiology of disease, physical diagnosis and medical interviewing, and to apply all of this to diagnose and care for individual patients. Health care professionals are taught to do their very best within the system and to perfect themselves by advancing their clinical skills and knowledge every day. Making a better system, however, requires analogous but somewhat different skills from becoming a better provider of health care.1

This section

Presents a review of concepts that will help health care professionals and payers effectively contribute to the process of systems change:

• understanding systems
• efficacy vs. effectiveness
• individual competency vs. system capability
• clinical research vs. quality improvement
• enumerative vs. analytic statistics.

Describes three levels of clinical recommendations:

• standards of care
• practice guidelines
• treatment options

Discusses barriers to change in the areas of health care professional knowledge, attitudes, and behavior.

Reviews effective interventions for changing behavior to help health care professionals, educators, payers, and employers use the most effective approaches to implementing change.

Lists organizations involved in certifying diabetes educators, accrediting medical education programs, recertifying physicians, developing competencies, and providing continuing education for systems change activities.

Lists resources and references that can provide a wealth of additional information.

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