Health care is facing rapid fire change that will require broad reforms in health care delivery. Changing demographics, increasing rates of chronic disease, advances in medical science, health information technology’s ability to make care safer and more efficient, skyrocketing costs, and the short- and long-term impacts of the Patient Protection and Affordable Care Act (ACA) all are strong drivers for reform of the entire system, from the education of our health care workforce to the system in which our care is delivered. As the Institute for Healthcare Improvement put forth in 2007 (Berwick D. The Triple Aim: Care, Health, And Cost. Health Affairs, 27, no.3 (2008): 759-769), improving health care delivery in the United States requires a focus on three areas:
- improving the experience of care
- improving the health of populations
- reducing per capita costs of health care.
All care providers will need new skills and knowledge to reach this triple aim. Physicians, especially, will need new skills to be able to lead and manage a reformed health care delivery system and be a meaningful part of the transformation. The move from individual health management to population health management and from individual performance to team performance needs to be embraced by the provider community.
With the passage of the ACA, the health care environment is specifically moving towards closer integration and alignment of physicians and hospitals through coordinated payments and accountable care. At the same time, the economic climate and the outlook of a new generation of physicians is moving the physician community toward employment and joint venture models to increase financial security and meet work/life balance goals. In fact, hospitals now employ more than 20 percent of practicing physicians, raising the importance of the competencies and the shared responsibility for achieving them. Finally, hospitals and health care systems are realizing the strength of increased clinical representation in leadership to help align interests. This strengthening of the relationship between physicians and hospitals should be leveraged for a coordinated approach to improving and valuing the competencies that lead to delivering high-value health care.
To that end, the Physician Leadership Forum has developed a white paper, “Lifelong Learning – Physician Competency Development,” which examines the skills needed to practice in the next generation of health care delivery. The paper discusses how hospitals and physician-associated organizations can help mold the next generation of physicians to function in a reformed health care delivery system that emphasizes team-based, value-driven care. The paper is the culmination of work with the AHA’s regional policy boards, governing councils and committees, the PLF Advisory committee and a clinical task force. “Lifelong Learning” includes case examples of activities underway at various hospitals and health systems throughout the United States to embrace a set of core competencies. The PLF is working with AHA members and a variety of physician groups to stimulate thinking about how hospitals can begin to ingrain the competencies into their organizations and help support efforts to move toward greater adoption of the competencies. The paper is available at www.ahaphysicianforum.org/competency.