Journal article proposes framework to guide career development in health systems improvement

Published on November 30, 2012 at 11:41 PM · No Comments

Journal article proposes framework to guide career direction, choices for physicians and others

The sheer number of efforts aimed at improving the quality and efficiency of the U.S. health care system - ranging from portions of the national Affordable Care Act to local programs at individual hospitals and practices - reflects the urgency and importance of the task. One aspect that has received inadequate attention, according to three physicians writing in the January 2013 issue of Academic Medicine, is training the next generation of experts needed to help lead these efforts. In their Perspective article, which has been released online, the authors propose a framework for career development in what they call "health systems improvement," a term that encompasses a broad range of activities - including management, research and public policy - to improve the quality and efficiency of our systems of care.

"My co-authors and I each had experience in nonclinical fields such as government, consulting or law before entering medical school, leading to countless conversations with our classmates and co-residents about atypical career paths," explains Clay Ackerly, MD, MSc, management and policy fellow at Massachusetts General Hospital and the Massachusetts General Physicians Organization, a co-author of the Academic Medicine article. "During these conversations most trainees echoed common themes of wanting to have careers that allow them to improve the quality of our care delivery systems. However, most of them also had difficulty articulating their exact interests, and it became clear that we lacked a common lexicon to discuss their specific interests and potential career opportunities."

The authors - also including Ami Parekh, MD, JD, medical director of Health Systems and Innovation at the University of California, San Francisco, and Daniel Stein, MD, senior medical resident at Brigham and Woman's Hospital - write that while a few academic medical centers have developed programs addressing health systems improvement, many medical trainees "may become overwhelmed by the sheer number of, and lack of clarity among, possible career paths." Since many of today's health care leaders reached their current positions through what the authors call "circuitous and often serendipitous career paths," their ability to guide and advise young physicians may be limited.

Based on a series of conversations with medical students, residents and leaders in health systems improvement, the authors put together their framework. It starts with three core focus areas - research, policy and management - defines three intersections - policy advising, policy translation, and implementation science - and includes examples of potential careers, such as academic administration, health services research and government relations.

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