The next step in spread­ing the Kaiser way? Train­ing docs

Modern Healthcare - - NEWS - By Adam Ruben­fire

Kaiser Per­ma­nente is preparing to in­still its ap­proach to low-cost, high­qual­ity care in the minds of fu­ture physi­cians. The Oak­land, Calif.-based sys­tem plans to open an in­de­pen­dent med­i­cal school in Southern Cal­i­for­nia, with its first class ex­pected to en­roll in fall 2019.

“We’re not just launch­ing an­other med­i­cal school,” Kaiser CEO Bernard Tyson said. “This is really a med­i­cal school in which we’re bring­ing for­ward all the knowl­edge and where­withal we’ve ac­cu­mu­lated over the years, as our physi­cians con­tinue to in­no­vate and drive pop­u­la­tion health and in­di­vid­ual health.”

Pri­mary care will be a fo­cus in the new school, a Kaiser spokesman said. While stu­dents will choose their spe­cialty, Kaiser expects many to fo­cus on pri­mary care and go on to work at Kaiser. By train­ing the Kaiser sys­tem, “stu­dents will ex­pe­ri­ence pri­mary care at its best— demon­strat­ing a vi­able life­style and the re­spect pri­mary-care physi­cians de­serve but do not al­ways get in the med­i­cal com­mu­nity,” the spokesman said.

Kaiser says physi­cian ed­u­ca­tion hasn’t evolved to sup­port mul­ti­site, high­tech­nol­ogy health­care de­liv­ery. The school will em­brace ad­vanced mod­els of de­ci­sion­mak­ing, team­work, tech­nol­ogy, ev­i­dence-based medicine and com­mu­ni­ca­tion strate­gies tai­lored to spe­cific pop­u­la­tions.

Al­though most med­i­cal schools teach two years of ba­sic sci­ences and two years of clin­i­cal skills, Kaiser stu­dents will be able to ap­ply lessons to pa­tient care from day one. “It’s not just about car­ing for dis­ease but car­ing for the whole pa­tient,” said Dr. Ed­ward El­li­son, ex­ec­u­tive med­i­cal di­rec­tor and chair­man of the board for Southern Cal­i­for­nia Per­ma­nente Med­i­cal Group. “Physi­cians in train­ing will get to know pa­tients in the com­mu­nity in which they re­side, and be­gin to think about sys­tems of care de­liv­ery and so­cial de­ter­mi­nants of care.”

Such clin­i­cally rel­e­vant train­ing is the fo­cus of sev­eral in­no­va­tive un­der­grad­u­ate and post-graduate pro­grams that pro­vide course­work in qual­ity im­prove­ment and hands-on clin­i­cal in­struc­tion early in their cur­ric­ula. The Univer­sity of Mis­souri School of Medicine, the Hof­s­tra North Shore–LIJ School of Medicine and the Her­bert Wertheim Col­lege of Medicine at Florida In­ter­na­tional Univer­sity have each launched pro­grams that in­volve med­i­cal stu­dents in pa­tient care within their first two years, ac­cord­ing to the Com­mon­wealth Fund.

Kaiser is tak­ing the rare step of cre­at­ing its own med­i­cal school, in­stead of part­ner­ing with a univer­sity, as in re­cent deals made by North Shore-LIJ in New York and Beau­mont Health in sub­ur­ban Detroit.

“It’s a part of the chang­ing face of medicine, and we cer­tainly wel­come new ideas, and wel­come Kaiser in this new world,” Dr. John Prescott, chief aca­demic of­fi­cer for the As­so­ci­a­tion of Amer­i­can Med­i­cal Col­leges, said.

Kaiser lead­ers have spent the past five years craft­ing a plan for the school, which expects around 44 stu­dents in its in­au­gu­ral class. Tyson said Kaiser still has to work through the de­tails of how the school will be funded, but the sys­tem will con­sider us­ing com­mu­nity ben­e­fit fund­ing to sup­port some of its ex­ist­ing med­i­cal ed­u­ca­tion pro­grams. Kaiser al­ready op­er­ates a School of Al­lied Health Sci­ences in Rich­mond, Calif.

More than 600 physi­cians are com­plet­ing res­i­den­cies at Kaiser fa­cil­i­ties, and af­fil­i­ated pro­grams send sev­eral thou­sand more to the sys­tem for a por­tion of their train­ing. Kaiser has 38 hos­pi­tals and a large net­work of clin­ics that serve over 10 mil­lion mem­bers in eight states and the Dis­trict of Columbia. The sys­tem re­cently an­nounced that it would ac­quire Seat­tle-based Group Health Co­op­er­a­tive.

“We have a rich history in teach­ing physi­cians. This is the miss­ing piece of the arch,” El­li­son said.

Kaiser also an­nounced that Dr. Christine Cas­sel would leave her role as CEO of the Na­tional Qual­ity Fo­rum to join a team of lead­ers tasked with de­sign­ing the school’s teach­ing ap­proach.

Kaiser un­der­stands that it is in­vest­ing in the un­der­grad­u­ate train­ing of its own fu­ture physi­cians, said John Lutz, a man­ag­ing di­rec­tor with con­sult­ing firm Huron Health­care. By train­ing physi­cians in the sys­tem’s care model well be­fore their res­i­den­cies, the school may bet­ter pre­pare doc­tors to work for the sys­tem, which could boost Kaiser’s pop­u­la­tion-health met­rics, im­prove ef­fi­ciency and drive down costs if its grad­u­ates are hired down the road.

“It is an in­vest­ment that should re­sult in a pos­i­tive re­turn if it re­tains its best pro­gram grad­u­ates,” Lutz said.

“This is really a med­i­cal school in which we’re bring­ing for­ward all the knowl­edge and where­withal we’ve ac­cu­mu­lated over the years, as our physi­cians con­tinue to in­no­vate and drive pop­u­la­tion health and in­di­vid­ual health.” BERNARD TYSON CEO, Kaiser Per­ma­nente

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