Dr. Arthur Levine proposed:
A program to match medical students with moderately complex patients in order to develop a longitudinal relationship over the four years of medical education.
1. Students will develop a long-term relationship with a patient and their family throughout their medical school careers. They will appreciate the value of continuity of relationships within the health care system. These relationships will serve as a reminder to students throughout their medical education that the purpose of all their learning is to serve real people in need.
2. Students will examine the interactions, intersections and gaps between the various specialties and health professions that serve their patient.
3. Students will learn to serve as a coordinator of care for a complex patient case. Students will develop both written and oral skills to facilitate coordination of care.
4. Students will evolve from a lay advocate role into a more sophisticated advocate from within the health care community over the course of their medical school training.
- Patients and their families will benefit from a continuous relationship with an advocate within the health care community who understands the breadth and complexity of their needs and experiences and who serves as a repository of knowledge about the historical evolution of the patient’s case. Patients who do not otherwise have a “nurse or doctor in the family” will especially benefit from having a close relationship with a health care provider “in-training” that knows them well, and who stands with the family when relating to the health care team.
- The medical system as a whole benefits from the deliberate scrutiny of the health care system from a patient-centered perspective. Students will both identify gaps in the current system, and work to bridge those gaps as well.
“I think the most valuable part of this project so far, for me, is the opportunity to start to understand how one patient’s health and health care interacts with the rest of their lives. The opportunity to do this is not mirrored anywhere else in the medical school curriculum, as it requires many conversations with the same patient over an extended period of time. In my first visit or two with the patient, I learned a lot about their health, but I also could have learned a lot of that information by reading their medical record. As I visit with them more I feel like I am getting more insight into the patient’s family life and more social or psychological factors: e.g. who in their family they rely on most for support, what daily pressures or stressors they have to cope with, or how previous life events have shaped how they view their current medical condition.”
“’Continuity of care’, a catch phrase, a buzzword, gets tossed around as some nebulous concept by those trying to improve the lives of those who fall ill in our country. My experience with my Longitudinal Alliance patient has taught me the
power of continuity of care. Not in the sense that the same physician stops by every other week to check her blood sugars. The ‘continuity’ that seems most powerful is the constancy of the human connection. Our existence is that which is
woven into a rich social fabric. As health care providers, we have the opportunity to not only cure disease, but to re-stitch that which has come undone simply by being present, in every sense ofthe word. “