Learning from Global Colleagues
Hope that everyone had a great summer and is now back in the saddle for the fall. This is always a busy time but the activities ahead help to invigorate us all for the start of the academic year and the end of 2017. It is also a time to examine what we have learned over the year and how that new knowledge can help us to improve. As many are aware, your Board Chair Keith Benson and I spent a week in China this summer on behalf of AUPHA. The opportunity arose through an invitation from colleagues at the Tongji Health Management School in the Huazhong University of Science and Technology, Wuhan, China. They invited us to visit and consult with them about the prospects of attaining certification for their health administration program. We were also asked to give a keynote address for the Chinese Health Management Association Annual Meeting in Guilin, China. Both of these events occurred during the last week in July.
Keith and I both have many wonderful and enriching stories to tell about the trip and our colleagues in China. Many, however, concern the heat of inland China during the summer. More to the point, however, we reviewed their programs and learned a great deal about their health management education system. Tongji Health Management School has a strong program and their faculty appear to be some of the leaders in health management education within the Chinese education system. Their former Dean, for example, is still a faculty member but is also the founder and Director of the Chinese Health Management Association (CHMA).
There are many reasons for making this type of trip to a foreign land. While Tongji hosted us and transported us in China, it represented a substantial investment in our most precious asset, time. My experiences teaching and consulting in other countries, however, have always proved beneficial primarily because I learn so much regarding other ways to accomplish our common goals of preparing competent healthcare leaders. I must admit that the prospect of having colleagues from China expend the effort to seek AUPHA certification was a factor. Their involvement would greatly expand the scope of AUPHA globally. Beyond Tongji, the CHMA currently has 100 organizational members, thus the prospects of expanding certification beyond Tongji Health Management School had great appeal as well.
More important than membership, however, is the prospect of discovering how another system goes about preparing healthcare managers. Can we learn from their approach? Several key features were evident that I found relevant. First, labor is relatively cheap in China. Consequently, the numbers and types of people working in healthcare delivery is greater than in the US. They appear to be much more labor intensive than healthcare is in the US. The challenge of coordinating this workforce presents great challenges. Second, professional healthcare managerial roles are not yet as well established in China as in the US as far as I could tell. It seems that clinicians occupy most of the senior roles in the delivery system. It is unclear how much core management training these clinicians receive. Third, the undergraduate curriculum has a much heavier emphasis on clinical education for the future healthcare managers. They require dozens of courses that appear to increase competencies in basic medical and biologic sciences from anatomy and physiology to the domains of individual clinical specialties.
The question remains, how are they doing? I can say that based upon our review and detailed discussions with their leadership, they have developed an education program that mirrors many of the aspects of health management education that we see in the US. I must say, much more similar than I expected. They clearly have studied our programs and, in particular, our criteria for certification and created both core content and surrounding support systems that look strong. Clearly, much more detail would need to be examined carefully but there were few major criteria that they were missing entirely. Not unlike a US program coming up for its first certification review, there are areas of uncertainty with the Tongji Health Management Program. We did not see criteria that were so weak that they could not be fixed with additional effort.
There are some major obstacles, however. First of all, their application and supporting documents will need to be translated into English for us to perform the review. While that sounds like a technical problem that can be easily fixed, translation is tricky when you are looking at the nuance of description. For example, we seek input from alumni and practitioners to inform the content of our courses. We expect a formal mechanism for that to occur and for the process to be well documented. It was not clear how robust practice input has become in their system. The second obstacle involves the role of the “party” and central planning in Chinese education. There were mixed messages regarding the freedom they have over curriculum content. Finally, because the delivery system is different from ours in many respects, they are currently training folks for different roles than most US programs. We would have to critically evaluate their educational processes with regard to their program goals.
Finally, both an obstacle and opportunity exists in the focus of these programs. This is actually a point noted by Gary Filerman in his comments when receiving the AUPHA Leadership Award for Excellence in Global Health Management Education in 2013. Health administration education made great contributions to the performance of hospitals in the US over many years by relying on operations research systems engineering, organization and management, sociology and finance. The focus for global health systems that I noticed in China is on what Dr. Filerman called the “big picture” issues of inequality and access. While important considerations for sure, these beg the question of inequality of access to what services. Complex healthcare systems require professional, competent management to deliver care or global solutions such as universal insurance have little value. It would seem that this focus provides AUPHA member programs an opportunity to work with individual programs or groups of programs to assist them to lay the foundation for quality healthcare management education.
I am excited about the prospect of working with our Global Leadership Committee and others to expand AUPHA’s influence on healthcare management education throughout the world. In the meantime, I hope to have some of these conversations during the Undergraduate Workshop next month. Hosted by the University of Central Florida, October 5-7, the workshop will be a forward looking event and the theme Unique Challenges of Preparing Students for the 21st Century Healthcare Industry holds great potential. Our two keynote speakers should be both informative and entertaining. Michael Mayo, President, Baptist Medical Center Jacksonville, understands the academic and practice environments and will provide a wonderful start. At lunch, Lisa Cannata, Director of Organizational Readiness for Adventist Health in Orlando will share her experiences in developing the healthcare workforce.
Hope to see many of you in Orlando in October.