Beyond Flexner Is on a (Social) Mission

The importance of the Flexner Report on medical education cannot be overstated. When Abraham Flexner evaluated American and Canadian medical schools in the early 1900s, his findings brought about a complete overhaul of how health care providers are trained. No more for-profit institutions with shoddy standards. The new model focused on science and scientific discovery.

As important as the Flexner Report was in creating important standards and countless medical advancements, something in the process was arguably lost: seeing the patient holistically.

In 2012, the first Beyond Flexner conference was held in Tulsa, Oklahoma; the second took place last month in Albuquerque, New Mexico. With the tagline “Social Mission in Medical Education,” the Beyond Flexner “movement” aims to train health professionals as “agents of more equitable health care.” The conference focused on equity in access to care, diversity, interprofessional education, and team-based care. More than 350 people attended.

Though the conference was primarily geared toward the medical education community, other health professionals, including PAs, were in attendance. The impressive lineup of presenters is what motivated Theresa Horvath, MPH, PA-C, the program director at the Sophie Davis School of Biomedical Education and a previous PAEA board member, to attend.

“The conference featured the most important individuals advocating for social mission and social justice in medical education,” Horvath said. “I have read many of their works and was excited to hear them speak in person.”

Those speakers included Jack Geiger, MD, who famously wrote prescriptions for food in the 1960s, Donald Berwick, MD, MPP, the former president and CEO of the Institute for Healthcare Improvement, and Surgeon General Vice Admiral Vivek Murthy, MD, MBA.

The social determinants of health — the conditions in which people are born, grow, live, work, and age — were emphasized during the conference, along with health care professionals’ responsibility to address those factors when treating patients.

PAEA’s Academic Affairs Manager Zach Britt attended the conference and said the experience made him re-think whom to include when considering interprofessional health care. “When we think of team-based care, we think of PAs, nurses, physicians — maybe physical therapists, dentists — but we don’t tend to think of social workers, legal aids, fields like that.”

Horvath said her biggest takeaway was reflecting on the reasons why more students do not chose to go into primary care. “A number of the presenters spoke about the inability of health care workers in high-need neighborhoods to address the social needs of their patients, leading to discouragement and burn out,” she said. “I also learned about a number of models developed throughout the country that address that need.”

Attendees didn’t just hear about different models that are used to address social problems in medicine, they had the opportunity to see first-hand how they are being implemented. They were split into groups to visit 13 different community sites, including a Native American charter school, a ministry health clinic, a small farm, and a food bank.

“Going out and seeing these ideas in action was really important,” said PAEA’s Research Manager Rachel Hamann. “I think our members forget about the opportunity to do that via Project Access.”

Though Horvath found value in attending, she notes Beyond Flexner probably isn’t for everyone. “The whole conference was a bit unusual in that it was focused around a theme, social mission, rather than a profession or organization,” she said. “PA educators that have a strong mission — either personal or institutional — toward filling the health care workforce in areas of the country with the highest need would most benefit from Beyond Flexner.”

John Henning Schumann, MD, attended the Albuquerque conference and gives his take on NPR’s health blog. The next Beyond Flexner conference is scheduled for 2016 in Miami (dates not yet confirmed).