News and Commentary My Last Week as President

In my first talk to the Macy Board as President in January 2008, I listed the external factors and trends that were bringing about dramatic change in the health care delivery system, and I made the case that health professions education needed to change equally dramatically to prepare health care professionals for the world they will be entering.

The changes I suggested included:

  • new-models-for-clinical-education that are interprofessional, community oriented and based on principles of continuity;
  • new skills and content to complement the biological and clinical sciences;
  • greater attention to faculty development and diversity; and
  • a breaking down of educational silos within and across the professions.

While I saw some encouraging signs that our education system was beginning to respond, I felt much more change was needed and at a faster pace to better align health professions education with societal needs. I gave a roadmap for these changes, and this became the agenda for our work in the subsequent decade.

Our recently-released Special Report of the President reviews our accomplishments over the past ten years—an impact that we know is due to the hard work of our grantees, Macy Faculty Scholars and conferees. The period 2008-2018 has been one of great financial and political unrest, but in spite of this, I have seen more changes in health professions education in this decade than I have seen in any of my four prior decades as a medical educator. It has been very exciting to be a part of this change.

I am particularly proud of the role we have played in:

  • changing the national perspective on the importance and effectiveness of interprofessional education;
  • developing the next generation of leaders and change agents in health professions education;
  • improving nursing education and promoting nursing leadership;
  • improving the preparation of physicians so that they are better prepared for a changing health care system and have the necessary skills and attitudes to meet the current and future needs of their patients; and
  • stimulating and influencing the national dialogue on the importance of and the need for change in health professions education

I also realize that even if we have made progress in changing health professions education to better meet societal needs (and I do believe we have), the work is incomplete and there is still much more to do.

Later this week I will step down as President of the Macy Foundation. But I am confident that this current of change will prevail. After all, the enormity of the work that has been accomplished in the past decade has been a collective effort.

While continued unrest in the health care system and a polarizing political climate make precise predictions of the future even more difficult, I do not believe that they have altered the direction of the changes we envisioned ten years ago:

Healthcare will become more team-based, distributed, population and chronic disease oriented, and accountable to the public. And it will continue to be profoundly affected by new technologies, consumerism, concerns about cost, and the need for greater equity in access and outcomes.

Health professions education must continue to evolve, informed by delivery system and patient needs. And delivery system reform must make it a high priority to optimize education. For health professional education this is both a mandate and a blueprint for change.

Ten years from now, I look forward to reading about the changes you all have brought about to improve the health of the public.

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