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Radical Reform: CDC Director Urges "Schools of Health" to Foster Shared Mission Among Professions PDF Print E-mail
Written by John Weeks   

Radical Reform: CDC Director Calls for "Schools of Health" to Foster Collaboration and Shared Mission Among Healthcare Professions

Summary: Centers for Disease Control and Prevention director Julie Gerberding, MD, has stepped out of the box of the health reform debate. Gerberding believes that true reform of the US medical system requires us to establish "schools of health" in which professionals start their education together. The paradigm shift will foster cooperation and a sense of common mission. While not referring directly to the complementary and alternative professions, Gerberding's vision is deeply aligned with recommendations in a 2005 report from educators representing 12 complementary and alternative healthcare and integrative medicine disciplines. These pushes for multi-disciplinary collaboration also echo recommendations from the Institute of Medicine in its report on CAM in the United States. An Integrator reader urges a campaign to support Gerberding in continuing to promote this direction in order "to limit turf wars."
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Marie Shanahan, RN, HN-BC sent a note to the Integrator July 17, 2007, to enlist support for a campaign she initiated. The board-certified holistic nurse and consultant on integrated care with diverse health systems had spotted what she believed was a window of opportunity to foster fundamental change in the medical system.

CDC Director Julie Gerberding, MD
Shanahan, a principal with the Birchtree Center for Healthcare Transformation, opened her campaign this way: "
Dr. Julie Gerberding (MD), director of the (Center for Disease Control and Prevention) has made a radical statement." Shanahan referred to suggestions Gerberding reportedly made to reporters at a meeting of the American Veterinary Medical Association (AVMA). A Reuters article entitled "Start with Medical Training to Fix US Health Care: CDC Head" (July 16, 2007) quoted Gerberding making this blunt recommendation:
"I believe that what we really need in this country are schools of health."
What would characterize such a school? Gerberding doesn't think that merely running scores of thousands of professionals through typical medical education will create what we need. Healthcare and medical professionals need to start their education with a multidiscipinary experience which will foster both cooperation and a sense of common mission. States Gerberding:
"If we are seriously thinking about building a health system, then we need to be training professionals in a collegial and collaborative manner."
Gerberding believes that "we are at a tipping point with our health care delivery system." She believes the current system is focused too much on treating disease and on end-of-life care, with little attention paid to preventing disease and helping people lead healthier lives. Bottom line: "We cannot afford to continue going in the direction that our system is going."

Opening the Gerberding Opportunity: A Stakeholder's Campaign for Health and Collaboration

Marie Shanahan, RN, HN-BC - Holistic nurse and health activist
After Shanahan read the article - picked up by Medscape - she sent an impassioned notice to her list, which included the Integrator. Wrote Shanahan:

"I'm so impressed by this 'out of the box' thinking that I'm asking all of you to read it and consider passing it along to nurses, physicians and others that you know. In addition, I'm asking you to send a letter of support to (Gerberding). If we as healing professionals can understand each other and support one another in our common quest to offer the people in our care the best care possible, we will have come along way in making things better and making a difference!

"Something has to change and this is an idea that has real merit and possibility. Imagine no more turf wars, and greater collegiality. It could happen. It will happen if we believe and take action."
Gerberding can be reached at: Centers for Disease Control and Prevention, 1600 Clifton Road NE, Building 21, Mail stop D-14, Atlanta, GA 30333, or by faxing to 404-639-7111. Shanahan's sample letter is attached below.

Comment:  I was struck in reading Gerberding's vision, and Shanahan's appeal, by its resonance with the vision articulated by leaders of 12 healthcare disciplines organized as the National Education Dialogue to Advance Integrated Health Care: Creating Common Ground (NED). These educators in chiropractic, integrative medicine, massage therapy, holistic nursing, naturopathic medicine, acupuncture and Oriental medicine, holistic medicine, direct-entry-midwifery, yoga therapy and others agreed to the following mission:

We envision a health care system that is multidisciplinary and enhances competence, mutual respect and collaboration across all CAM and conventional health care disciplines. This system will deliver effective care that is patient centered, focused on health creation and healing, and readily accessible to all populations.
National Education Dialogue to Advance Integrated Health Care: Creating Common Ground (2005)
IOM Committee Chair Stuart Bondurant, MD
The consonance with Gerberding's recommendation is profound. Stuart Bondurant, MD, the chair of the  Institute of Medicine (IOM) Committee on the Use of Complementary and Alternative Medicine in the United States, affirmed this consonance in a statement about the National Education Dialogue activity:
"Our ultimate goal should be to create a healthcare delivery system that is comprehensive, patient-centered, evidence-based and cost-effective. What you are doing here (with the National Education Dialogue), this great collaborative work, is one of the most important things anyone can do to implement (the Institute of Medicine) report."
I credit Shanahan for recognizing a rare opportunity to shift the nation's debate over reforming its medical payment system toward engaging the more fundamental questions - the nature of healthcare education, for instance - which might lead us toward health. Medscape and Shanahan are not the only individuals, news-sources or blog sites that have gravitated toward this message. Gerberding's assertion that we need to work toward transformation rather than "reform" seems to have struck a chord.

My guess is that Gerberding doesn't even know how deep the alignment with her public health proposition is among many in integrative medicine and natural health care. This is a good chance to let her know. Who knows, maybe one day Gerberding will deliver her excellent message on the need for "schools of health" to the Association of Academic Health Centers rather than a gathering of those charged with the care of our Cocker Spaniel Ezzie and other non-human animals. Then again, the AVMA was probably a friendly audience for Gerberding's message. Vets have long evidenced a commitment to healing, including a respect for the role of nutrition in health, which surpasses that of their AMA colleagues.

Shanahan's Sample Letter to Gerberding

Dear Dr. Gerberding,

Today I read your comments from your address to the annual meeting of the Veterinary Medical Association. I support your proposal to have health professionals begin their education together and I call on other health professionals to lend their support as well.

We need more voices of leadership such as your own, calling for common sense and common ground in re-visioning a healthcare system that is truly about helping people gain their highest possible health status and ensuring that we as a nation can pass along a health system to future generations that is accessible, sustainable and humane.

Your idea is radical, yet simple. If we begin with a common purpose and learn to appreciate each discipline's perspective and contribution, it follows suit that we could and would collectively create a healthcare system that is holistic in its approach and healthy at its core.  In our training programs in hospitals, we bring together physicians, nurses, social workers, physical therapists, administrators, hospital chaplains and other health professionals to create healing environments for themselves and those in their care. I have witnessed first hand the remarkable synergy that comes from the group learning process. We all have a piece of the puzzle; we need to recognize we'll only succeed when we work together.

Thank you for proposing this idea. It is my hope that it will spark national dialogue and get people to think creatively about the tremendous job of reforming healthcare.

Sincerely yours,

Marie M. Shanahan, BSN, RN, HN-BC
President, CEO
The BirchTree Center for Healthcare Transformation

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