The United States faces a health care crisis: medical care is becoming prohibitively expensive, suffers from inconsistent quality of practice, and all too often is provided in an impersonal manner. These problems are found to a variable extent in health care systems in other countries as well. Given this, and given the fact that the United States health care system is commonly viewed as a model for others around the globe, the problems facing the American health care system have far-reaching ramifications. Health care disparities between poor and affluent patients have increased markedly in the past few decades. At the Center for Innovative Medicine, we believe academic medical centers like Johns Hopkins have an important role to play in addressing this crisis.
To that end, we are developing programs that encourage our researchers, clinicians, and nurses to work together on common problems and to concentrate their energies on the needs of all patients. As part of that effort, thanks to the generosity of Mrs. Aliki Perroti, we have launched The Aliki Initiative – an innovative project developed to re-establish the primacy of the patient in the training of young physicians. This novel educational program is designed to create a generation of physicians who treat all patients, regardless of their income or social standing, with compassionate, competent and personalized care.
Johns Hopkins Bayview Aliki Initiative
In 2007, the Center for Innovative Medicine at Johns Hopkins Bayview Medical Center launched the Aliki Initiative, a novel curriculum in patient-centered care for internal medicine residents and medical students. Under the direction of Dr. Roy Ziegelstein and Dr. Cynthia Rand, this program emphasizes that optimal medical care can be delivered only if medical treatments are tailored to the individual patient. During this experience, young physicians and physicians-in-training develop a deeper understanding of their patients' living situation and social support system. They call every patient and visit some of them at home after hospital discharge. The program, supported through the generosity of Mrs. Aliki Perroti, has been very highly evaluated by residents, medical students, and -- most importantly -- patients.
More than 50% of the patients admitted to the Johns Hopkins Bayview Medical Center are poor; 20% have no health insurance. Without access to personal physicians, these patients are completely dependent on the hospital’s dedicated and committed medical staff and trainees. Unfortunately, as skilled as these doctors and nurses are, the demands placed on their time as they provide care for the many very sick patients they are responsible for make it challenging for them to personalize care for each person’s needs and preferences. In this, they are not alone. Sadly, national data indicate that 61% of all patients feel their doctors do not know them as individuals. Ironically, most physicians are similarly frustrated that they are no longer able to take the time to know and understand their patients as individuals. For today’s young physicians in training, there is a serious risk that they may master the mechanics of delivering medical care, yet never have the opportunity to learn to the art of healing.
We have designed The Aliki Initiative to change this. Toward that end the specific aims of The Aliki Initiative are to educate medical residents to:
- Prioritize knowing their patients as people, not diseases
- Recognize that optimal patient care requires understanding the patients’ preferences, abilities, resources and family and social circumstances
- Address continuity of care by putting the acute episode of care (i.e., the care provided during the hospitalization) in the greater context of the patient’s life
- Focus on the patient in care decisions by communicating in a manner that is understandable to the individual, by making clear the primary role of the patient in all health care decisions, and by ensuring that the patient has the information and resources necessary to make informed health care decisions that are best for that individual
- Educate and empower patients to be active participants in achieving their health goals with providers as educators
For more information about similar initiative, please see the Johns Hopkins Center for Innovative Medicine website.