Back to Front PageVOLUME 6, NUMBER 4
 

We've been hearing a lot lately about "the new economy" and the many demands it is making on traditional ways of doing business. Prominent among those demands is collaboration. In the new economy, enterprises that insist on going it alone are likely to be left in the dust. As the pace of change accelerates and as work becomes more complex, the need to find partners with different skills and expertise becomes critical for survival.

Nowhere is this need more urgent than in medicine. In our fast-paced, increasingly complex world, partnering with other professionals to form collaborating teams is not only the wave of the future, it is the order of the day. As our population ages, as our science and technology advance, and as our work centers more and more on continuous care of the chronically ill and disabled, our health care work force must operate as collaborating units. Quality health care ceased being the province of solo virtuosos a long time ago. Yet, we are still struggling with precisely how to make health care the orchestrated team effort it must become.

There are many reasons why the struggle continues. For openers, we still educate different members of the health care team largely in isolation from one another. To expect students of various disciplines to emerge from an educational silo and function effortlessly in a multidisciplinary practice model is to expect too much. Further impediments to the needed transition to collaborating teams include the patchwork of state licensing and scope of practice statutes as well as the reimbursement system for professional services, which frustrates attempts to shift the unit of accountability for health care from the individual practitioner to the integrated team.

Adding even greater urgency to the call for teamwork among health professionals is the mounting evidence that serious shortages are beginning to emerge in several key fields, particularly in nursing and pharmacy. Demographic, economic, and sociologic factors all seem inexorably poised to diminish the size - and erode the quality - of the health care work force generally. As a result, the acknowledged interdependency that has existed rhetorically for decades among various members of the health care team is fast becoming a matter of survival. Finding ways to redefine and restructure our work as health care professionals is not only the right thing to do for quality patient care, it is likely to be the only option available to adapt to the diminished number of individuals entering various health care occupations in the coming decades.

In the meantime, medicine must do all it can to ensure that its partner professions in the health care enterprise remain strong and continue to attract talented young people to their ranks. In this connection, I'm extremely proud that the AAMC has been able to reach agreement with our colleagues at the American Association of Colleges of Pharmacy (AACP) to create a unique cooperative venture under the banner of PharmMed Educational Services Inc.

Designed to develop programs and services of benefit to both professions, the first task of this nonprofit corporation is to develop a centralized application service for students applying to schools of pharmacy. At present, prospective pharmacy students must apply separately to all schools of interest and must conform to a variety of deadlines and procedures. The Pharmacy College Application Service (PharmCAS), patterned after the AAMC's highly successful AMCAS program, will enable students to file a single application for all schools participating in the service. Our hope is that this streamlined process will both encourage more qualified students to seek the PharmD degree and enable participating schools to devote more of their effort to recruitment.

But PharmMed has the potential to do a good deal more than operate a centralized application service. We believe that cooperative activities between pharmacy and medicine can contribute greatly to such common concerns as faculty development, interdisciplinary research, curriculum enhancement, and institutional management.

Moreover, we hope that the success of PharmMed will spark interest in collaboration among other health professions. If the AAMC and its counterpart organizations can become a model of collaboration for our constituents, perhaps we can hasten the day when practitioners from all disciplines adopt truly collaborative team care as the norm for our health care system.

Henry Ford once said, "Coming together is the beginning. Keeping together is progress. Working together is success." Medicine is a far cry from automobiles, but Ford's adage sounds right to me.

 

Jordan J. Cohen, M.D.
AAMC President

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