ARTICLE: New Medicine for the U.S. Health Care System: Training Physicians for Structural Interventions
Hansen, H, Metzl, JM. New Medicine for the U.S. Health Care System: Training Physicians for Structural Interventions. Academic Medicine 92(3):279-281, March 2017.
The current moment presents an unprecedented opportunity to shift clinical training in the United States from a focus on technological intervention toward provision of more comprehensive health care–care in which students, interns, residents, fellows, and faculty engage with neighborhood organizations, non–health sector institutions (e.g., schools, corrections, housing), and policy makers to promote patient and community health. The Affordable Care Act of 2010 and state-level Medicaid redesign, informed by the Institute for Health Innovation’s “triple aim” of improving population health and patient satisfaction while reducing cost, have provided a new clinical focus on social and institutional determinants of health. A groundswell of physician advocacy groups, such as Partners in Health, White Coats for Black Lives, and Health Begins, are calling for a foregrounding of health disparities in clinical training and practice. In addition, the Robert Wood Johnson Foundation, the nation’s largest private funder focused on health, recently announced “building a culture of health” as its core principle, signaling its support for multidisciplinary efforts to improve the social conditions, policies, and service infrastructures that drive health inequalities.