My Patient. Your Patient, Our Patient: Making Medicine Better for Everyone

Too many patients complain about having doctors and other experts who fail to consult with each other or who provide contradictory directives. Medical and health professions schools can tackle the problem by fostering the professional cooperation and coordination that all patients deserve.
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Meet Evelyn, a 68-year-old widow with Type 2 diabetes, a stent and memory loss. She's getting thinner and won't take her medication.

Evelyn has multiple medical needs, so her physician, physical therapist, nurse and other experts all have different views about priorities for treatment. Thankfully, however, now they're working together. They talk frequently with one another, and each recognizes how one medical decision affects other aspects of Evelyn's care.

Team-based and patient-centered care approaches are critical as we face physician shortages in certain areas along with greater numbers of patients who have increased access to health care from the Affordable Care Act. Doctors, nurses and other health care professionals must work together -- and training in teamwork must start early in their education.

Too many patients complain about having doctors and other experts who fail to consult with each other or who provide contradictory directives. Medical and health professions schools can tackle the problem by fostering the professional cooperation and coordination that all patients deserve. That close collaboration starts when students from different specialties train together and appreciate each others' important roles.

At New York Institute of Technology, faculty at our medical and health professions schools created Evelyn as a fictional case for a special exercise on inter-professional education. Actors, also called "standardized patients," played the roles of Evelyn and her feuding children who made the case even more complicated with their disagreements about her care.

The exercise forced students to consider numerous medical, ethical, and social concerns. As they wrestled with Evelyn's prognoses and prescriptions, they learned the importance of considering the perspectives of an assortment of colleagues on the treatment team. The physician needed to understand Evelyn's physical therapy needs; the occupational therapists voiced concerns about Evelyn's ability to engage in activities of daily living. The PA, nursing and mental health counselor weighed in, raising other practical, ethical and medical issues.

Students in the audience helped evaluate the exercise. Most agreed the simulation helped them understand ethical dilemmas and increased their appreciation of professionals outside their own disciplines. Recently, we presented another case featuring a young, married veteran struggling with a traumatic brain injury and other physical and emotional disabilities.

Earlier this year, the Institute of Medicine released a report on measuring the impact of inter-professional education in various areas, such as patient safety and satisfaction, care quality, and cost savings. We believe that students who receive inter-professional education will be better prepared to work with their colleagues to provide optimal, compassionate care.

Academic leaders may find it difficult to integrate these types of exercises into information-saturated curricula. It may be costly, and it certainly requires considerable planning. Yet, it deserves time and resources.

As medical simulations and inter-professional exercises play a larger role in education, we're building a better health care workforce where collaboration is the norm and clinicians possess the technical and interpersonal skills to provide patient-centered care at the highest level.

Patricia M. Chute is Dean of NYIT School of Health Professions (Chute was not compensated for writing this piece by a third party)

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