The next step in spreading the Kaiser way? Training docs

Kaiser Permanente is preparing to instill its approach to low-cost, high-quality care in the minds of future physicians. The Oakland, Calif.-based system plans to open an independent medical school in Southern California, with its first class expected to enroll in fall 2019.

“We're not just launching another medical school,” Kaiser CEO Bernard Tyson said. “This is really a medical school in which we're bringing forward all the knowledge and wherewithal we've accumulated over the years, as our physicians continue to innovate and drive population health and individual health.”

Primary care will be a focus in the new school, a Kaiser spokesman said. While students will choose their specialty, Kaiser expects many to focus on primary care and go on to work at Kaiser. By training the Kaiser system, “students will experience primary care at its best—demonstrating a viable lifestyle and the respect primary-care physicians deserve but do not always get in the medical community,” the spokesman said.

Kaiser says physician education hasn't evolved to support multisite, high-technology healthcare delivery. The school will embrace advanced models of decisionmaking, teamwork, technology, evidence-based medicine and communication strategies tailored to specific populations.

Although most medical schools teach two years of basic sciences and two years of clinical skills, Kaiser students will be able to apply lessons to patient care from day one. “It's not just about caring for disease but caring for the whole patient,” said Dr. Edward Ellison, executive medical director and chairman of the board for Southern California Permanente Medical Group. “Physicians in training will get to know patients in the community in which they reside, and begin to think about systems of care delivery and social determinants of care.”

Such clinically relevant training is the focus of several innovative undergraduate and post-graduate programs that provide coursework in quality improvement and hands-on clinical instruction early in their curricula. The University of Missouri School of Medicine, the Hofstra North Shore–LIJ School of Medicine and the Herbert Wertheim College of Medicine at Florida International University have each launched programs that involve medical students in patient care within their first two years, according to the Commonwealth Fund.

Kaiser is taking the rare step of creating its own medical school, instead of partnering with a university, as in recent deals made by North Shore-LIJ in New York and Beaumont Health in suburban Detroit.

“It's a part of the changing face of medicine, and we certainly welcome new ideas, and welcome Kaiser in this new world,” Dr. John Prescott, chief academic officer for the Association of American Medical Colleges, said.

Kaiser leaders have spent the past five years crafting a plan for the school, which expects around 44 students in its inaugural class. Tyson said Kaiser still has to work through the details of how the school will be funded, but the system will consider using community benefit funding to support some of its existing medical education programs. Kaiser already operates a School of Allied Health Sciences in Richmond, Calif.

More than 600 physicians are completing residencies at Kaiser facilities, and affiliated programs send several thousand more to the system for a portion of their training. Kaiser has 38 hospitals and a large network of clinics that serve over 10 million members in eight states and the District of Columbia. The system recently announced that it would acquire Seattle-based Group Health Cooperative.

“We have a rich history in teaching physicians. This is the missing piece of the arch,” Ellison said.

Kaiser also announced that Dr. Christine Cassel would leave her role as CEO of the National Quality Forum to join a team of leaders tasked with designing the school's teaching approach.

Kaiser understands that it is investing in the undergraduate training of its own future physicians, said John Lutz, a managing director with consulting firm Huron Healthcare. By training physicians in the system's care model well before their residencies, the school may better prepare doctors to work for the system, which could boost Kaiser's population-health metrics, improve efficiency and drive down costs if its graduates are hired down the road.

“It is an investment that should result in a positive return if it retains its best program graduates,” Lutz said