We live in a world that is rapidly evolving and changing. The future is uncertain as policies change, as well as politicians. No one can predict what 2017 or future years will herald. We watch as dozens of news stories pour into our mobile apps every time we check in. And for those of us that practice medicine, health care research, and news coverage can change the way we approach our patients almost daily.
While it is hard enough for doctors to keep up with all the advancing technologies and new innovations, patients are also being flooded with information, sometimes making them question if their health care provider is keeping up to date. It seems that patients fall into two main aggregations: people who are genuinely confused and misinformed about the health news they read and hear; and patients who are savvy, educated and empowered as citizen scientists that own their conditions and treatments. Now more than ever, we need to be addressing both sets of patients and facilitating dialogue while also keeping providers current.
The future of continuing medical education
One way that doctors stay atop the learning curve is by participating in continuing medical education (CME) activities. According to the Accreditation Council for Continuing Medical Education (ACCME), there are nearly 1,900 CME providers across the nation. Those in the AACME system provided over 148,000 educational activities in 2015, equaling over one million hours of education.
Yet, there is a divide between where and how CME providers offer education and what clinicians need. Like much of the world, digital technology has changed the way doctors and health care providers learn. Traditionally, doctors took time away from their practices to attend onsite CME conferences. However, doctors’ time is ever more constrained. As they spend more time in billing and documentation, they have less time to see patients and struggle to attend CME programs in person.
In response, the medical education landscape has been evolving to meet the bandwidth challenges of doctors with an array of digital formats, ranging from live virtual events that recreate the interactivity of in-person learning to on-demand videos, podcasts, peer-reviewed articles, and audio recordings. Online CME is growing in its availability and is already the go-to for time-strapped physicians, 91 percent of whom report having participated in online CME. But the many digital formats available risk diluting the learning experience, and thus, retention of critical information. As doctors become more pressed to find face-to-face time with their patients, it’s imperative that they have access to comprehensive online programs that equal or surpass traditional in-person CME conferences.
CME needs to translate directly into patient outcomes
Additionally, CME has been challenged on a variety of fronts to prove its effectiveness in recent years and in the wake of the Affordable Care Act and CMS’ drive towards a value-based health care system. Today, there are higher expectations that CME credits translate directly into better patient outcomes. Independent medical education has fallen under much scrutiny. In one example, the CDC director, Thomas Friedan addresses the failure of his agency to make progress against “winnable battles, ” and it is apparent more help is needed. Doctors cannot do it alone.
“Medical education needs to evolve to where there is aligned learning between health care providers and patients. True collaboration and shared decision-making can only occur when this exists,” says Christian Rubio of PlatformQ Health, a leading provider of online CME and patient education. “Furthermore, we need all health care providers from specialist physicians to PCPs to nurses to physician assistants to pharmacists to anyone interacting with a patient to learn at their own level of training.”
Shared education: Aligning clinician and patient education
This is where a “shared education” model that aligns knowledge and enhances trust between provider and patient has great potential. As stated by Mr. Rubio, everyone in the healthcare setting needs education at their own level, from patients, to nurses, to doctors, to anyone interacting with patients at any level. If anyone in that continuum lacks that “shared education,” we fail as providers, and we will never achieve the optimal outcomes for our patients.
Life-long learning empowers doctors because it establishes the evidence of what is needed for good outcomes. This begs the question, if we expect a measurable, regulated approach to clinician education, why don’t we expect the same from patient education?
“Most patient education is too often awareness-focused and light on impact, or it is clinical but meant to induce demand for a specific treatment or brand that a clinician must then confront and clarify,” says Rubio. “The impact is muted in the former and potentially negative in the latter, and can make for a confrontational experience between the patient and their clinician. Education that aligns patients and clinicians keeps these key stakeholders current and collaborative, at their levels of understanding. And this learning must be aimed at reducing the time to correct diagnoses and maximizing good clinical outcomes”.
Empowering patients to make informed decisions
Gone — in many ways thankfully — are the days of the paternalist model of medicine where “doctor knows best” is the tagline. Today, patients are increasingly empowered to take part in their own healthcare journeys through access to online information. But they can only do that effectively when their decisions are guided by advanced educational sources. We all know the web is riddled with a confusing mix of good and bad medical advice along with clever swindlers of mythical medicines.
Additionally, patients’ medication adherence and lifestyle changes are critical aspects of most treatment protocols, a realm where doctors have little control beyond the few minutes of encouragement during visits. And if the history of patient adherence to medications and lifestyle in the areas of obesity and diabetes management are indicators, doctors, and their educators are in for a tough road. “Shared Education” is crucial in our current medical reality.
In our ever-evolving world of fast-paced medical innovation, this needs to become the gold standard of medical care: properly educated clinicians and patients. Only when we align our knowledge and participate in shared decision making can we truly do our best for patients and allow them to make the best decisions.
Linda Girgis is a family physician who blogs at Dr. Linda.
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