Perspectives from Stakeholders
In the final formal set of presentations of the workshop, four representatives of national organizations provided differing perspectives on the future of allied health.
THE NATIONAL SOCIETY OF ALLIED HEALTH
Allan Johnson, associate dean of the Division of Allied Health Sciences in the College of Pharmacy, Nursing, and Allied Health Sciences at Howard University and a professor in the Department of Nutritional Sciences, provided a perspective from the National Society of Allied Health (NSAH), which is a membership organization of historically black colleges and universities with programs in allied health. The NSAH’s major goal is to improve the health status of African Americans and other economically disadvantaged groups through research, education, employment, and community services.
Johnson cited three obstacles that face the field of allied health. First, it lacks a cohesive identity. This is partly because of the large number of allied health professions, but it also has not succeeded in conveying to other health care workers and to the public knowledge of the roles of allied health professions. The wide variety of program names for these fields in educational institutions is an indication of this problem.
The name allied health is also a problem, Johnson admitted. The impression it can convey is that allied health professionals are not really health professionals rather, they are just “allied” to health professionals. Allied health professionals sometimes engage in counterproductive turf battles,
Johnson said. As examples, he cited tensions between physician assistants and nurses, between occupational therapists and physical therapists, and between certified diabetes educators and registered dieticians.
Finally, many allied health professions lack diversity. Yet minority health professionals provide the majority of health care to the poor and underserved. Diversity provides for greater access to care, greater patient choice and satisfaction, and better educational opportunities for health profession students, Johnson said.
To have a greater influence on health policy, the allied health professions need to develop a brand identity, Johnson concluded. There needs to be an atmosphere of respect and appreciation for the roles of allied health professionals among policy makers, the general public, other health professionals, and allied health professionals. Position papers on the impacts of new policies, testimony at congressional hearings, and a lobbying organization for allied health could all promote the causes of cohesion and advancement.
THE NATIONAL NETWORK OF HEALTH CAREER PROGRAMS IN TWO-YEAR COLLEGES
Many of the messages heard at the workshop resonate with the goals of the National Network of Health Career Programs in Two-Year Colleges, said Carolyn O’Daniel, dean of Allied Health and Nursing at Jefferson Community and Technical College in Louisville, Kentucky, and president of the network. Examples include the emphases on team-based care, chronic care, increased accountability, career pathways, and work-based learning. Many of the barriers discussed at the workshop also are of particular concern to community colleges, including scope-of-practice silos, definitions of professionalism, and the difficulty of identifying the optimal mix of health practitioners.
A unifying strategy, she said, would be the implementation of a core health care curriculum. An interdisciplinary core curriculum could streamline educational processes, improve efficiencies, promote teamwork, and prepare students for changing workforce demands. Similarly, effective partnerships and coalitions among educational institutions not only leverage resources but improve planning.
Career pathways offer the best hope for meeting the needs for various levels of care in a variety of settings, said O’Daniel. Community colleges need to work with partners at both the front end and the back end to create seamless articulation and transparent pathways. Also, work-based learning can increase diversity, promote job satisfaction, improve retention, and decrease costs, all of which will be necessary in the future.
Accountability measures for programs receiving public funds must be
extended if students are to be protected and if those funds are to produce the needed outcomes, said O’Daniel. In addition, interdisciplinary teamwork must be modeled by faculty and incorporated into programs, and clinical practice must include more than just acute care settings.
A unified voice that can promote recognition and influence policy requires valid and timely data. Also, job forecasting requires complex environmental scanning capabilities. Employers must be at the table and willing to share data.
Community colleges are critical partners in health care workforce preparation and particularly in establishing and enabling career pathways, O’Daniel concluded. In the process, they diversify health care, promote economic development, and improve the lives of their students.
THE ASSOCIATION OF SCHOOLS OF ALLIED HEALTH PROFESSIONS
Richard Oliver, dean of the School of Health Professions at the University of Missouri and chair of the Government Relations Committee for the Association of Schools of Allied Health Professions, made 18 points about the barriers and opportunities facing allied health.
- State practice acts are wildly inconsistent and need to be reconciled.
- Accreditation standards need to be driven by outcomes.
- The current lack of diversity constitutes a crisis in public health.
- Reimbursement needs to create incentives for team-based care, and education programs should create the skills to work on teams.
- Inadequate health literacy among patients is a problem that extends across all health professions and must be addressed in part through what Oliver described as “stupid stuff,” like calling patients after an appointment to make sure that they understood what was said, have filled a prescription, and have made another appointment.
- Technology has the potential to transform both higher education and medicine, from courses delivered by cell phone to virtual physicians and professors.
- The lack of doctorate-trained faculty in allied health is a major problem, especially in areas where related disciplines cannot fill vacancies.
- Continual turf battles detract from the need to generate more primary care practitioners than there currently is capacity to generate.
- Emerging professions, many created by new technologies, are a tremendous opportunity for students, both those in specialized programs and those in general health science bachelor’s programs.
10. Change needs to occur at a much faster speed than is typically found in higher education to accommodate the pace of change in modern society.
11. The tendency for proprietary schools to pay for clinical training experiences is driving other students out of clinical sites.
12. Partnerships with community colleges need to extend beyond articulation agreements to genuine partnerships.
13. The extension of the electronic health record to the personal health record controlled by the consumer is an exciting area of growth.
14. The things industry expects of people with advanced degrees can differ from the skills developed in getting those degrees.
15. Career ladders need to become more transparent, more seamless, and easier to navigate.
16. Institutions need to identify needs and then develop programs to meet those needs.
17. Allied health professionals need to be more vigilant and vocal to avoid being like copilots who passively watch pilots fly planes into mountains.
18. Outcomes research, such as could be generated through a postacute care registry, could produce great efficiencies.
THE HEALTH PROFESSIONS NETWORK
The Health Professions Network, formed in 1995, comprises national leaders from allied health professional associations, all levels of educational institutions, accrediting agencies, and health care professionals with representation from each of the 50 states. The organization has two major goals, said its president, Lynn Brooks. It seeks to market careers in allied health, and it wants to address the barriers to advancement of allied health workers.
In part through biannual meetings of a very wide variety of allied health professionals, it has sought to institute an interdisciplinary dialogue to look for common ground in allied health. “We did not want to focus on the differences. We wanted to focus on what we could do to pull everything together,” said Brooks.
The network also has increased its efforts to market health careers. “We do not want allied health to be the default job. We want it to be the first pick.” Drawing inspiration from the Discover Nursing campaign supported by Johnson & Johnson, the network developed a program to refine its message, in part through focus groups that could identify perceptions of health careers. Seeking to brand allied health and articulate it as an industry, it outlined press releases, media training, talking points, brochures, presentations, a website, and other materials. However, the recession of
2008 made it difficult to find financing for the campaign. Instead, it began building a partnership that could take the marketing program nationwide. These partners, in turn, have many of the resources and capabilities called for in the promotional campaign.
In the process of developing the campaign, the Health Professionals Network was able to reidentify and specify many of the long-range barriers and opportunities that are factors in allied health, such as educational staffing and resources, recruitment and retention, the provision of accurate and timely data, economic support, the uneven distribution of workers and needs, inadequate diversity, and developing “clout” for allied health. To address these barriers and opportunities, the network is putting on a series of webinars, summits, and conferences. It also is collaborating with the Department of Labor to create a competency model for the different areas of allied health.
“We have the greatest industry going in the country,” said Brooks. “We are hot. We have been for years. Our salaries, benefits, and opportunities are good. But our problems are immense, and we are not working through them as fast as we could.” The Health Professionals Network is committed to overcoming these barriers, Brooks concluded. “We do not want the future to create us. We need to create the future.”
During the discussion period, Johnson said that minority students need to know more about allied health. “Most of these students are interested in medicine, and sometimes dentistry. So I have to alert them to the fact that there are other health professions.” Students also need better preparation in mathematics and the sciences to start taking college-level classes immediately.
In response to a question about why there has been so much reluctance among baccalaureate programs to accept credits from community colleges, O’Daniel said that community colleges have been working on this issue for many years, though success has been limited. In the state of Kentucky, she said, a recent initiative brought together 2-year and 4-year institutions to develop an articulation program. “We had statewide buy in for it. So I know it can be done.”
Oliver, in answering a question about collaborations between universities and community colleges, pointed to the importance of trust. He also described how gratifying it is to see allied health programs in community colleges transform the lives of students, many of whom are from nontraditional backgrounds.
