Health Professionals
It is important to note that health professionals, within the current educational framework, tend to experience different levels of training, which translates to the divergent variations in medical specialists’ competencies. By being educated in a separate manner, they bring varying levels of expertise to the single labor market of healthcare. Therefore, the presented approach presents a wide range of issues, primarily manifested in three key areas. These include educational costs, educational efficiency, and patient care quality.
Costs
The first important aspect of separate education and training is reflected in educational costs. A study suggests that “high costs, which are often multifaceted and hidden, can impede the development and implementation of locally relevant educational resources, including those that support procedural training” (Kaplovitch et al., 2019, p. 713). In other words, each medical education facility is forced to spend more on important and costly tools needed for educating students. By being isolationists, such organizations are not able to share costly tools and instruments with each other. The main reason is competition between such medical schools, which need to have better equipment to be more appealing. These investments are transferred onto students, who become burdened with higher student loans making them financially impaired for longer.
Educational Efficiency
The second major issue of separate and isolationist medical education practiced in the current system is educational efficiency. A high level of competition between medical schools results in a divergence from the core objectives of healthcare. Experts state that “medical education reform should not be reduced to an “either/or” approach, but should blend theories and approaches to suit the needs and resources of the populations served” (Holmboe et al., 2017, p. 574). In other words, there is a divide of focus and attention of medical schools, where they are forced to either be competitive and appealing for students or primarily focus on education, which addresses population needs. Therefore, the current framework of medical education is not efficient in preparing competent healthcare professionals.
Patient Care Quality
The third and biggest problem of separate medical education is patient safety. It is stated that “growing concerns over patient safety have influenced not only the way medicine is practiced – with the widespread introduction of protocols, checks, and audit – but also the degree to which doctors are now publicly accountable” (Swanwick et al., 2018, p. 4). In other words, medical students need to be exposed to real patients in order to gain improved experience, but some medical schools have better options compared to others, which results in a disparity of practical gain knowledge and skills. Not all medical students come from background of excellent medical school, which is why poorly educated health professionals pose a risk to patient safety since they enjoy the privileges and responsibilities of all healthcare specialists.
Mal-Distribution
It is important to note that maldistribution is a major issue and contributor to healthcare inequality. The dire impact is most evident in the deprived regions, where the demand for healthcare is highest compared to supply. Research suggests that “rural areas that can least afford to lose physicians are those dealing with difficulties of increased mobility” (McGrail et al., 2017, p. 327). However, there are clear patterns of movement among physicians, which can explain the possible causes of rural healthcare professional shortages. Although there is no clear data on why physicians leave rural regions, the evidence on the following slides will provide possible reasons for such mobility among healthcare professionals.
Despite incentives designed by the government in order to retain physicians in rural areas, the mobility of the professionals overwhelmingly favors metropolitan areas. A study states that “Individual physicians more often left rural areas if they were female, international medical graduates, not of rural origin, or working in counties adjacent to metropolitan areas” (McGrail et al., 2017, p. 327). In the case of female physicians, it is possible that they leave rural areas due to starting a family, giving birth to a child, and the lack of infrastructure to raise children in rural regions. International medical graduates are likely to use rural areas to enter the American job market and gain experience. In addition, leaving adjacent rural areas is easier than non-adjacent ones due to proximity and connectedness.
The physician mobility can also be the result of short-term placement goals. It is stated that “shortly after residency, physicians may choose initial employment locations based more on availability than on preference until their preferred option becomes available” (McGrail et al., 2017, p. 328). In other words, many residents become physicians in rural areas, and then they relocate to their preferred locations. In addition, “given a choice between a rural town with strong growth vs a rural town with no growth or even slowly dying, the latter would deter most individuals” (McGrail et al., 2017, p. 328). Therefore, the rural regions with no economic prospects will deter the physicians seeking rural areas, and the ones that are there will likely leave.
Healthcare Delivery System
The current medical education and training are primarily focused on treating already acquired illnesses, injuries, and other health issues. The shift in the healthcare delivery system with an emphasis on prevention of health problems and maintenance of wellbeing means that the current health experts might not be equipped with the necessary knowledge and expertise. The requirement for skills, experience, and abilities in order to ensure sustenance of health involves behavioral guidance, lifestyle assistance, nutrition, and injury prevention. It is not evident whether or not the current medical education system generated healthcare professionals equipped to deal with such tasks. The following slides will primarily focus on injury prevention and nutrition as main examples since there is valid and reliable evidence on the subject.
Nutrition
In order for a person to remain healthy and avoid various health issues, one must adhere to proper nutrition and dietary standards. A study suggests that “nutrition is insufficiently incorporated into medical education, regardless of country, setting, or year of medical education” (Crowley et al., 2019, p. 379). Therefore, many nations, including the US, have generated healthcare experts without any expertise in health sustenance. It is stated that “deficits in nutrition education affect students’ knowledge, skills, and confidence to implement nutrition care into patient care” (Crowley et al., 2019, p. 379). In other words, the proposed shift in the healthcare system will need a major change in the education system and re-training of the current professionals.
Injury Prevention
Another major element of health maintenance and preventative measures in regards to diseases is injury prevention. It should be noted that traumatic injuries are the major cause of death among people aged 1-44 years old (Schmitz et al., 2018). An analysis of the medical education system reveals that “there is a knowledge gap in providing injury prevention education” (Schmitz et al., 2018, p. 700). The current medical schools do not equip physicians with sufficient knowledge and skills to prevent injuries, but they are competent at treating them. Therefore, the proposed shift will also need to incorporate injury prevention into medical education.
References
Crowley, J., Ball, L., & Hiddink, G. J. (2019). Nutrition in medical education: A systematic review. The Lancet Planetary Health, 3(9), 379–389. Web.
Holmboe, E. S., Sherbino, J., Englander, R., Snell, L., & Frank, J. R. (2017). A call to action: The controversy of and rationale for competency-based medical education. Medical Teacher, 39(6), 574–581. Web.
Kaplovitch, E., Otremba, M., Morgan, M., & Devine, L. A. (2019). Cost-efficient medical education: An innovative approach to creating educational products. Journal of Graduate Medical Education, 11(6), 713-716. Web.
McGrail, M. R., Wingrove, P. M., Petterson, S. M., & Bazemore, A. W. (2017). Mobility of US rural primary care physicians during 2000–2014. The Annals of Family Medicine, 15(4), 322–328. Web.
Schmitz, E., Figueira, S., & Lampron, J. (2018). Injury prevention in medical education: A systematic literature review. Journal of Surgical Education, 76(3), 700-710. Web.
Swanwick, T., Forrest, K., & O’Brien, B. C. (2018). Understanding medical education: Evidence, theory, and practice. The Association for the Study of Medical Education.