With more health care data available than ever, physicians are being asked to think in broader terms. Population health management, which focuses on health outcomes for a group of individuals rather than a single patient, has become a point of emphasis as across-the-board quality health outcomes have become a more significant metric for success in medicine.
With that, what is expected of a physician has changed from the era when doctors were principally responsible for the patient in front of them, said Paul George, MD, MPHE, assistant dean for medical education and associate professor of family medicine at the Warren Alpert Medical School of Brown University. “And now as a physician, to better health care systems, you are asked to be responsible for not only the patient in front of you, but also the population of patients.”
A patient’s well-being is often significantly impacted by social and behavioral determinants—such as access to transportation, nutritious food options and housing. Those factors cannot be treated during an office visit.
The topic is addressed in detail in the “Population Health” chapter in Health Systems Science, a 2016 textbook that is the first to explore the “third pillar” of medical education. (The chapter was written by Natalia Wilson, MD, MPH, with co-authors Dr. George and Jill M. Huber, MD)
This reality could be a bit of shock to medical students looking at the profession from a traditional standpoint.
“This whole concept—thinking also about groups of patients, using data and considering the community and the social determinants of health—is not necessarily something students came to medical school thinking they were going to be doing or learning about,” said Dr. Wilson, clinical associate professor at Arizona State University’s School for the Science of Health Care Delivery.
Misunderstandings abound
Within the text of Health Systems Science, population health is defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.”
Making that definition stick is the first step of the population health curriculum Dr. Wilson teaches to her students.
“There’s a lot of misunderstanding about what population health actually means and how it pertains to health care as well as the other areas we need to be thinking about in order to improve population health,” Dr. Wilson said. “Basic education is needed on key concepts and how things are changing in health care delivery for a population health focus.”
In addressing a more rounded approach to her students, Dr. Wilson is trying to pass along the knowledge that traditionally siloed areas such as health care delivery, public health and community organizations, will need to learn to work together for better health of patients and populations.
The significance of the lessons learned in the classroom, Dr. Wilson believes, will reveal their value over time.
“One of the challenges for medical students is they are starting their education, and so have not yet had significant patient care experiences and clinical training to fully understand the context and application of this new knowledge on population health,” she said.
“So we are planting the seeds for these important concepts we [physicians] need to know. My suspicion is that they will increasingly understand the importance of considering the social determinants of health, using data to provide knowledge about their patient populations, and collaborating with partners to support the health of their patients and populations as they progress in their education and clinical training.”
Health Systems Science, which is already in use in medical schools across the country, was co-written by experts from the AMA and faculty from 11 of the 32 member schools in the AMA’s Accelerating Change in Medical Education Consortium.
The book retails for $59.99 and can be ordered from the AMA Store and the publisher, Elsevier, as well as from Amazon and other online booksellers. AMA members may order it from the AMA Store for $54.99. Individual chapters are available from Elsevier’s Student Consult platform for $6.99 each.
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