Leadership through partnerships with other schools and associations
Health provision is undergoing a seismic transformation around the world. Health knowledge, technologies, and the skills that these demand are exploding at all levels, with no one cadre able to “do it all” and with all cadres requiring critical support from one another. Traditional relationships between medical doctors, nurses, midwives, community health workers, and other cadres (such as information technology specialists, medical technicians, and logisticians) are in flux.
Relationships between different health professional cadres have often been hidebound as a result of governance practices and parameters designed in the past century. As a result, many professional associations perform more as guilds, seeing their licensing roles as a shield rather than viewing population health goals as the primary focus. Health professional school leaders can provide objective and evidence-based bridging services, facilitating coordination and cooperation between professional associations and helping to revise national service policies and rules. Both because of the knowledge resources they can bring to bear and their broad perspective on health challenges, professional school leaders can be a trusted interlocutor between the various elements of the health system. To date, however, this comparative advantage has been significantly underutilized.
Health professional schools have a unique opportunity to exercise leadership within the health system by partnering with each other and professional associations. Through partnerships, schools and associations can pool resources and conduct training that includes multiple cadres. In this way, prospective graduates can become used to working in multiprofessional teams, helping make the adjustment to practice less difficult. Schools can also work together and with their associations to reverse many damaging trends in health professional education. This includes “credential creep,” in which professions lengthen the time and the cost it takes to train a credentialed professional and obtain the foundational degree (certificate, bachelor’s, master’s, or doctorate), despite evidence that this practice effectively decreases access to care (Frenk et al. 2010). Another damaging trend is “academic shift,” in which schools focus less on the actual daily competencies that a given cadre will need and more on theoretical background; this, too, can only be addressed with schools as partners. Schools can work together to emphasize the importance of clinical knowledge and skills alongside theory.
A number of countries have been moving in the direction of lateral partnerships. Examples include:
- Bangladesh: The Bangladesh Ministry of Health, as the earliest world leader in health “sector-wide approach” (SWAp) strategies and financing, explicitly included national medical associations and academic postgraduate societies in its annual SWAp and consortium reviews and policy reviews, jointly with other health sector domestic and international partners.
- Canada: The University of Toronto Sandra Rotman Center and University Health Network brings the university’s health professional schools together with health insurance industry, pharmaceutical, and medical technology competencies to explore innovations and better ways to collaborate.
- Kenya: The government of Kenya, under the aegis of the East African Community (a regional intergovernmental organization) jointly with the African Development Bank, is engaging with the country’s medical schools. The latter are shaping interdisciplinary education, training, and research in biotechnology, health economics, insurance, emergency medicine, and trauma innovations across sectors and traditional disciplines.
- Malaysia: The National University of Malaysia, in the context of reviewing academic policies and its role in the future, has engaged the wider Malaysian society in a two-way discussion on the social relevance of the university as well as engagement in cross-sectoral issues such as nutrition, trauma policies, and the interface between different professions and cadres.
- Netherlands: The University of Groningen’s health and medical school is leading the country’s healthy aging policies with innovations, research, and education across multiple fields such as molecular biology, biophysics, macroeconomics of aging, law and labor policies, and ambulatory, preventive, and clinical care of aging.