Redesigning LSU Graduate Medical Education
I am writing in response to recent public comments made by detractors about LSU Health’s graduate medical education that are misinformed and represent an old world view of our health care delivery system. Healthcare costs are too high and the quality of care could be better. So, as a nation and as LSU Health, we are transforming our healthcare delivery system to improve quality and affordability of health care. So, too, LSU Health must transform and modernize our graduate medical education (GME) to match the new emerging models of care. Healthcare is no longer hospital centric or specialty centric as some might have you believe. It is becoming data driven, evidence-based, patient-centric care. That means medical education has to move beyond primarily being in the hospital and follow the patients into a variety of clinical settings. Hospitals as large pillars of graduate medical education are transforming to serve as one cog among many in the clinical path patients follow toward better health.
The Institute of Medicine (IOM) made note of the fact that clinical care had moved beyond the hospital as the primary setting of care. More care is being delivered in numerous other places. The Institute wondered about the impact the changes in care settings would have on GME. So, the IOM is convening a national panel to develop specific recommendations to the Congress related to GME. Their scope of work broadly covers new GME governance systems and improved means of financing for GME. Just over a week ago, the IOM panel launched their first public meeting considering, among other agenda items, the need for GME training in a variety of settings, for more training in primary care, and training in outpatient clinics.
In addition to the Institute, the Association of American Medical Colleges (AAMC) has several initiatives to transform medical education to incorporate the national trends in patient-centered quality programs into GME. The AAMC seems to have noticed the same transformation in health care discovered by the Institute of Medicine. LSU Health and our GME programs are beginning our redesign efforts, too. LSU Health is participating in the AAMC joint efforts to improve GME. We work closely with the AAMC programs, sharing information so that we can learn along with other medical schools about the changes we face.
Let’s bring this discussion home to our patients at LSU Health. We are fortunate to have had recent experiences that have opened our eyes to the opportunities in our local community. These opportunities have led to an enhancement of our GME. One example shares a lesson learned from Hurricane Katrina. When the storm arrived, we instantaneously lost our Charity Hospital and the GME programs within the hospital were threatened. Prior to the storm, we had most of our GME programs living in the various silos of care at Charity Hospital. Over the years at Charity, we saw our patient volumes decline and our available technology become dated. Our GME programs struggled in the constraints of a public hospital system. We were living in an arcane model of care.
In response to the storm, in order to treat our patients and to save our GME mission, we had to follow our patients into the surrounding communities. LSU Health also had to establish new clinical partners in each setting to allow for patient care and for continuation of GME for our students and residents. At first, the radical shift in care settings, with new partners, had us worried. We were concerned our faculty and training programs would lose patients and the volumes necessary for adequate training experience. We were wrong to worry.
Instead, the result was a terrific success. To our delight, we improved in the volume of clinical care in our GME program. Through these new care settings, the LSU patients, students and residents gained access to modern technologies, too. In our new partnerships, we discovered the resources needed to undergo the transformation of care we knew our GME programs would need. What we discovered was a better way to educate our future health care providers. Our patients had the same LSU doctors, also new doctors and better, more affordable care. Imagine that! We learned that new partnerships between LSU and the community would be the necessary catalyst for redesigning our graduate medical education.
Our new community partners benefited also. LSU Health brought the vitality of our graduates into new communities. We brought the youthful, inquisitive and energetic minds of nursing students, allied health professionals and young physicians into each community partner. What better way to promote retaining our health care workforce in our home state?
In these challenging times, LSU is once again seeking renewed and new relationships with the delivery systems around us. We hope to leverage those relationships for closing gaps in clinical care, modernizing the LSU brand of care, and map the redesign of LSU GME in these programs. We are joining the IOM and the AAMC in rethinking the path for LSU GME. We are relentless in our effort to improve. It is a perfect time for LSU to examine and redesign our clinical care models and our graduate medical education simultaneously.
Dr. Frank Opelka, LSU Executive Vice President for Health Care and Medical Education Redesign