Medical school prepares doctors for practice in managed care settings

Most of tomorrow’s physicians will find themselves working in some type of managed care setting, and the Medical School plans to ensure that doctors of the future are prepared to work in new practice environments.

With the help of a $375,000 federal grant from the Health Resources and Services Administration, the school this year made several curriculum changes aimed at achieving the goal.

Beginning with the class of 2002, UW Medical School graduates will:

• Understand how health care is organized, delivered and financed in its various forms in this country.
• Know more about how to make decisions about patient care through rigorous use of the best available evidence and principles of population health, which includes information about demographics and socio-cultural factors that affect health and disease.
• Be able to identify and address ethical issues unique to the practice of medicine in a managed care context. Experts expect that more than two-thirds of Americans with health insurance soon will be covered through health maintenance organizations or similar managed care systems.

“Medical students need to learn more than just medicine today,” says Susan Skochelak, the school’s senior associate dean for academic affairs. “The new curriculum emphasizes patient care management and community health, preparing students for practice in managed care environments, where typically the dual goal is improved health care and reduced costs.”

With the new skills and knowledge, doctors will be ready, for example, to advocate for patients’ special care needs beyond those that are ordinarily covered. They will know which diagnostic tests are both most clinically effective and cost effective.

And they will be better able to recognize and address common mental health issues in their patients, which account for up to one-third of patient visits to primary care clinics.

New partnerships with local group practices and managed care organizations have been, and will continue to be, crucial to the new effort, says Skochelak. UW Health/Physicians Plus, the UW Medical Foundation, University Community Clinics, and Unity and Physicians Plus health plans are all members of the initiative.

“These partners strongly support our efforts and work with us extensively in designing a curriculum that’s useful and practical,” she says. “They are providing community settings where the concepts and skills presented in our revised core curriculum can be reinforced.”

Skochelak says an important secondary goal is revising residency training programs offered through UW Hospital and Clinics to reflect the managed care concentration.

“The most effective way to teach these principles is to make sure all instructors – – residents and faculty alike — are knowledgeable and comfortable with these skills in their own practices,” she says, adding that faculty have expressed strong interest in the new curriculum.

UW Medical School began a major curriculum revision in 1993 with the Generalist Partners Program. The goal of the program is to interest medical students in generalist medical practice by introducing them to primary care clinical situations from their first days at medical school. Skochelak’s efforts to implement the GPP won her the 1997 Patient Care Magazine award for Innovative Family Medicine Education.