Educators Consider Impact of Supreme Court Ruling on Teaching Health Professionals

Educators across UCSF are considering the implications of the newly affirmed health care law on teaching future pharmacists, doctors, nurses and dentists.

Scott Reeves, PhD, says the ruling by the Supreme Court to uphold President Obama's health care law will have “profound implications for the creation of new and the expansion of existing interprofessional education and interprofessional collaboration activities across the country.”

Reeves, who joined UCSF in December as the founding director of the Center for Innovation in Interprofessional Healthcare Education, came at the right time.

“The inclusion of more than 30 million people into the health care system will demand that health professionals work together more effectively to provide services, which are safe, timely and well coordinated,” Reeves said. “This creates further demand for inteprofessional education, which can provide professionals with the skills, knowledge and ability to be effective collaborators. As a result, this is a truly historical event for interprofessional education.”

UCSF School of Pharmacy health policy professor Helene Lipton, PhD, agrees. Lipton has devoted her professional career to developing, implementing and evaluating innovative models of team-based care, focusing on pharmacist-physician collaborative models.

“The Affordable Care Act transforms our current delivery system through encouraging team-based care,” said Lipton, a faculty member of the Philip R. Lee Institute for Health Policy Studies in the UCSF School of Medicine.

“The act creates programs such as medical homes and accountable care organizations to enable all health care professionals to improve the quality of care by practicing to the top of their licenses,” she said.

Increasing Health Care Workforce

Currently, the U.S. is facing a national shortage of primary care physicians and the workforce has to expand to meet the needs of the newly insured.

David Vlahov, PhD, RN, dean of the UCSF School of Nursing, says advanced practice nurses are well prepared to meet these demands.

“The Supreme Court’s decision provides continuation of the provisions in the Affordable Care Act. The implications are vast — increasing the number of people who enter into the health care system, coordination of care between health professions, and funds to prepare practitioners and quality educators.”

Vlahov says advanced practice nurses have and will continue to play an important role in health reform. 

“When Medicare was enacted, many millions entered into the health care system, and that was the beginning of the nurse practitioner movement,” he said. “The new law again increases the need for advanced practice nurses, who working with physicians and other health professionals, will step up to meet the need not only in primary care, but also in specialty care, inpatient care, outpatient care and community health.”

UCSF educators say the nation must train greater numbers of health professionals to enter the workforce to meet the demands of new Medicare enrollees and aging baby boomers.

“We are witnessing nothing short of a ‘ silver tsunami,’” Lipton said. “The fact that one out of every eight seconds another American is enrolling in Medicare will have a profound impact on health care. And right now we don’t have the workforce to meet the demand.”

Many of those being added to the health insurance rolls are the elderly and poor and these patients are chronically ill.  

“And what is the treatment of choice for most chronic conditions,” Lipton asks. “Drugs! The health reform act gives pharmacists increased opportunities to serve as medication experts, advising physicians, nurse practitioners and other professionals about how to prescribe drugs that are safe, effective and affordable.”

Vlahov also sees a need to recruit more health professionals into academia because the faculty are aging, too.

“We expect a fair amount of retirement over the next decade,” he said. “Now is the time to begin preparing enough practitioners to meet the growing need. We also need to train more nursing educators — highly qualified educators to train the practitioners."

To lure more students into the profession, the nation will have to offer more financial assistance to attend health sciences universities and graduate with less debt.

“Loan repayment programs serve as incentives for getting people into nursing education, and they are going to be important to maintain,” Vlahov said.

Joseph Castro, PhD, vice chancellor of Student Academic Affairs, hopes that the widespread public attention to the high court’s ruling will spark interest among young people to pursue careers in health care.

"The Supreme Court's landmark decision, while very important in so many respects, may also inspire more of our most talented and diverse young women and men to pursue a career in the health sciences,” he said. “We will need such energy and talent to fulfill the promise of providing quality health care at an affordable cost throughout the nation."

Creating Innovative Programs 

And once they arrive to graduate universities like UCSF, institutions must be prepared to educate and engage students and trainees in a collaborative environment.

“The challenge for us as a leading academic medical center is to create innovative, interprofessional education programs so that all of our students, trainees and faculty can learn about the expertise and roles that each health professional brings to improving patient care,” Lipton said. “UCSF is making progress, but we need to increase the momentum to ready our students to meet the exciting challenges that lie ahead.”

UCSF must also be flexible and adapt to the ever-changing health care environment.

“We need to try new things — innovate — quickly and adopt what works, abandon what does not and adapt things that might work in one environment to be relevant to other environments,” said Sunita Mutha, MD, interim director of the Center for Health Professions at UCSF. 

“The center has always focused on developing the workforce and will continue to do so with renewed invigoration,” she said. “We also will accelerate our work on improvements and innovations in care. We believe our role is one of facilitator, convener, bridge builder, and an honest broker of describing what is happening and serving as a guide for what is possible. That’s a tall order, but we have amazing faculty and staff, incredible assets to build from across the UC system and partnerships with key stakeholders in the health care system in California and across the nation.”

Jeffrey Norris contributed to this report.