For years there is talk about interprofessional teams. For more than 20 years, educators and policymakers have put this forth as part of the health care vision for the 21st century. It is also directly and indirectly referred to in health reform legislation before the Congress. Policymakers are enamored of the idea of an interprofessional team of caregivers providing patient centered care (whatever that means).
I learned about some of the latest innovations in interprofessional programs in academic health centers throughout the nation. Students from two or more health professions are educated together and/or engage in practice together and, in so doing, are not only improving the learning environment but also patient care and outcomes.
Rural practitioners tend to embrace interprofessional practice more fully than practitioners anywhere else in the country for obvious reasons. However, in the last decades, interprofessional education has not gone mainstream and been fully embraced by health professions schools and academic health centers. Interprofessional activities have been person directed (by a passionate advocate), thus remaining at the margins of health professions education. Passion on the part of institutions is not quite as evident.
What’s the problem. Money is always an issue. With universities and hospitals waiting for the next budget cut, institutions are hampered from creating new programs so needed for the future. In addition, we still don’t have enough evidence that such practices make a difference. There has not been enough study of the long-term impact of interprofessional initiatives. Research is needed. And that also cost money. Regulations don’t support it. State licensing boards and accreditation agencies often inhibit innovation within institutions. Scope of practice laws are barriers to interprofessional practice. Faculty incentives are still based on what makes a difference to the “profession,” whichever that may be—thus making it hard to engage appropriate teachers in the process. Finally, the current health care delivery system—specifically the reimbursement system—does not support interprofessional practice—and may not support it for the future.
The bottom line: Interprofessionalism lacks focus. There is no standardization, no uniformity anywhere in the nation. There is no framework for programs, policy or practice. There is no infrastructure and no guidelines for establishing the infrastructure that is needed within institutions, particularly academic health centers where most of health professions education takes place. To fill this void, leaders of academic health centers are engaging on the issue—not only to mainstream interprofessional education and practice but to educate policymakers about the best way to deliver care for the future.
