From School of Medicine to School of Health

Maggie Fox, Health and Science and Editor for Reuters, has just reported a new voice in the debate over health care reform:

Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, stepped into the debate over health care reform with a call for changing the way doctors, nurses, veterinarians, pharmacists and dentists are educated.

Not only are more schools needed, Gerberding said, but these professionals need to start their education all together, to foster cooperation and a sense of common mission.

"I believe that what we really need in this country are schools of health," Gerberding told reporters at the annual meeting of the American Veterinary Medical Association.

"If we are seriously thinking about building a health system, then we need to be training professionals in a collegial and collaborative manner."

My immediate reaction to this new call to arms is whether it involves anything other than changing a name. Fox provides only one example of what Gerberding seems to have in mind:

Gerberding said the system is focused on treating disease and on end-of-life care, with little attention paid to preventing disease and helping people lead healthier lives.

Perhaps Gerberding might think twice about playing the name game if she realized that there already is a label for this alternative perspective: When the words are taken literally, it is called "health maintenance." Had this phrase not been so contaminated by health-maintenance-as-industry, she might have recognized the semantic interpretation it deserves.

However, this little word game gets to a problem Gerberding never bothers to recognize. Whether your call it "medical care" or "health maintenance," the process is about far more than learning how the body works and learning the proper practices of diagnosis and treatment. The real world of health care is now a world of an "industrial complex," chock full of all the negative connotations that Dwight Eisenhower assigned to the "military-industrial complex." The real problem with health care is the dominating mindset of profit-based business thinking; and, unless we can all come up with the right way of casting health care in terms of the sort of customer service problem that those businesses understand, new approaches to training health care professionals will probably not have much impact. Unfortunately, the way most of the business world deals with customer service these days, we should applaud any health care operation with the good sense to avoid that paradigm! However, the real moral of this story, to paraphrase Talleyrand-Périgord once again, is that health care is far too serious a matter to be left to those with the credentials of a Doctor of Medicine!