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    Population health expert highlights medicine’s 'third pillar'

    As the healthcare industry continues to explore and define population health strategies, it is important that upcoming physicians have a foundation in the topic.

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    Natalia Wilson, MD, MPH, authored the “Population Health” chapter of the Health Systems Science textbook that is expected to be used in medical schools across the country. The book was released in December 2016, and is a first in an effort by the American Medical Association (AMA) to educate medical students about the “third pillar” of medicine. This education initiative includes patient safety, quality improvement, teamwork, leadership, healthcare policy and economics, clinical informatics and population health. The textbook was co-written by members of AMA’s Accelerating Change in Medical Education consortium.

    “Population health is a dynamic area that is continually evolving, thus necessitating innovation in our approach to teaching, frequent update of our teaching materials, and consideration of new methods of practice for medical students and trainees,” says Wilson, a clinical associate professor at the School for the Science of Health Care Delivery at Arizona University, who teaches at the Mayo Clinic School of Medicine.

    Wilson talks with Managed Healthcare Executive (MHE) about the importance of population health being taught to the next-generation of physicians, and how it will transform care in the future.

    MHE: How much are population health strategies being taught in medical schools today?

    Wilson: Population health is a relatively new curricular area in medical schools that is expanding and evolving. Inclusion of population health curriculum and approach to education differs between medical schools. For instance, at Mayo Clinic School of Medicine, medical students are required to earn a certificate in the science of health care delivery that is jointly taught with Arizona State University.

    Examples from other medical schools include opportunity to pursue a dual Doctor of Medicine/Master of Science degree in population health, a population health scholar track, and involvement in population health initiatives during medical school.

    MHE: What are some of the basic concepts that new physicians need to understand about population health?

    Wilson: Accountability and responsibility for physicians is expanding to include the health of populations or groups of patients along with the traditional individual patient focus. Only 10% of the determinants of population health is attributed to healthcare. The majority is attributed to social circumstances, environmental factors and behavior.

    The social determinants of health are recognized to be very influential on behavior and to contribute significantly to differences in health outcomes between groups of people. Improvement of population health will require focused work, influence and collaboration between multiple sectors that include healthcare delivery, the community, public health, policymakers, payers, employers and research.

    MHE: How do you see population health changing what is being taught in medical schools?

    Wilson: I see population health as augmenting and complementing the traditionally taught basic and clinical sciences. A population health focus has evolved in response to significant limitations in health and healthcare. The United States has high levels of chronic disease, an obesity epidemic, high healthcare costs, disparities in health and healthcare, and relatively poor population health. What has become necessary in response to these problems is expansion of knowledge and experiences for medical students, those training in health professions and in practice so considered in patient care is the impact of social determinants of health, community resources that could be used to support patients, data to better understand patients and groups of patients, health IT that can expand the reach of care, and a team approach. Very importantly, we are planting seeds in medical students that they are part of the solution.

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