A Bill Evans Trio jazz standard serenaded an audience of health professionals at the Medicine X | Ed conference, held this fall at Stanford University.
It was hard to miss the impeccable musical coordination between the pianist, the bassist, and the drummer. Paul Haidet, MD, used the improvisational jazz band as a metaphor for how healthcare practice should be: well coordinated, with team spirit, and equal partnership. Today, however, doctors, nurses, pharmacists, and social workers in the US are more likely to follow disconnected protocols when helping patients than to trust and share perspectives that could advance patient outcomes.
The overarching theme of Medicine X | Ed was to advance communication within the healthcare system and with patients. This is the “art of medicine,” said Haidet, the Director of Medical Education Research at Penn State University.
"Between Sets" Credit: Johnathan Nightingale / Flickr
Cells in our immune system constantly communicate to effectively tackle pathogen attacks; mutual cooperation is equally valuable for healthcare professionals. However, strong power differentials exist between doctors, nurses, and pharmacists, which often hinder meaningful interaction. “I believe we need to teach both listening and valuing each other’s perspectives at the same time,” he said. To get to a truly interprofessional system of healthcare, it is vital to begin at school and continue the practice all the way to patient wards, Haidet pointed out.
Talking about interprofessional education, Associate Dean at UCSF Global Health and Innovations, Tina Brock, EdD, narrated a story about healthcare in Namibia. The southwest African nation has the highest incidence of tuberculosis, and a very high number of patients affected by HIV/AIDS, but an incompatible number of healthcare specialists. To change that, the University of Namibia started local training programs in 2010 for clinicians, pharmacists and physicians all in one place, because patients in Namibia needed their health professionals to work together. “Here in the US, we’ve drifted apart,” Brock said. “We need to do a better job of learning from others.”
Happily, UCSF is redesigning their curricula to bring students from medicine and pharmacy together, Brock told me after the talk.
There are a few such programs running in the US. Heather Davidson, PhD, spoke about the Vanderbilt Program in Interprofessional Learning (VPIL) in Nashville, Tennessee, where she is Program Development Director. One way they achieve common understanding is by having all students interact with a patient and then exchange notes. Davidson reported that students felt very comfortable learning from each other in an interdisciplinary education system and felt better prepared to listen and work together. “What we’ve learnt is that by creating space for interprofessional learning to really happen in authentic ways, we have the ability to transform the system on multiple levels – for the individual, for the clinical workflow and even for patients,” Davidson told the audience.
It gets better. Direct patient involvement in the development process can further drive improvements in healthcare and research.
E-patient advisor, Emily Kramer-Golinkoff’s story at the Medicine X | Ed conference was proof that patient-aided interdisciplinary work can accelerate treatment discovery. A cystic fibrosis patient herself, Emily enabled seamless collaboration between researchers, healthcare providers, community members and the industry through Emily’s Entourage, a non-profit fund-raising organization, to fast-track research on her rare mutation. “I realized I could wait on the sidelines and pray for a miracle or get into the game and try to make one,” she said. Her hack is working: awaiting FDA approval, she will begin the NF1 clinical trial in six weeks.
In his closing remarks, Haidet continued his jazz metaphor, calling to foster “synergy that leads to healing for the band, for the team, for the audience and for the patient.” “If it were up to me, I would get doctors, nurses and pharmacists to have lunch together on the wards,” he said. “Because unless we know each other as human beings, we can’t really play the music together.”
About the Author
Devika Garg is a science writer in the SF Bay Area. You can find her on her webpage: www.devikagb.com.