The concept of value-based health care — better outcomes at lower cost — is part of the foundation of Dell Medical School. But to make the changes we want in medical education and health care delivery, we need to extend our reach far beyond Austin. We know medical training environments have life-long effects on physicians’ medical practices, so if we want to reorient the system toward value, we should start as far upstream as we can in medical training.
Last weekend, we hosted 50 first-year medical students from 25 medical schools across the United States at Dell Med to do exactly that — engage future physicians in spreading the movement of value-based health care. The Choosing Wisely STARS (Students and Trainees Advocating for Resource Stewardship) program is based on a simple idea: activate medical students to lead change within their own medical schools by providing them with support and resources.
This model was introduced in 2015 by the Choosing Wisely Canada STARS program. During the first year of the program, Canadian medical students led several projects to advance Choosing Wisely, a campaign launched in 2012 by the ABIM Foundation to encourage clinicians and patients to discuss medical tests and procedures that may not be necessary. These students started local Choosing Wisely interest groups or journal clubs for their classmates. Some met with educational leaders at their schools and had this content more formally integrated into their curricula. They met with and became national leaders in Canada for Choosing Wisely in medical education.
The Austin Summit
At our Choosing Wisely STARS Leadership Summit, supported by the Josiah Macy Jr. Foundation, ABIM Foundation, Choosing Wisely Canada and Costs of Care, we shared ideas and resources related to Choosing Wisely, health care value, leadership and advocacy. The summit focused on sharing the vision of a better health care system that is centered on outcomes that matter to patients, addresses costs of care and is organized around the needs of patients.
Guest speakers included Ari Hoffman, assistant professor of Medicine at the University of California, San Francisco; Amit Pahwa, assistant professor and director of the internal medicine sub-internship at John Hopkins University; David Ansley of Consumer Reports, sharing Choosing Wisely resources; and Karen Born, a leader of the Canada STARS program, along with Canada STARS student Catherine Friedman.
Our 50 first-year medical student attendees had a great time at the summit, not only because it was capped off with an evening at Stubb’s BBQ, but also because they learned about how to lead. All of the students completing our anonymous post-survey (100 percent) agreed that they felt more prepared to lead discussions at their medical school about Choosing Wisely following the summit.
Now that the summit has ended, the students — along with their local faculty mentors — are joining a learning community to share stories of success and challenges, as well as to learn about resources and models that they may adapt locally. One example is our freely available Dell Med “Discovering Value-Based Health Care” interactive learning modules.
One of our favorite quotes, attributed to Antoine de Saint-Exupery, is “if you want to build a ship, don’t drum up people to collect wood and don’t assign them tasks and work, but rather teach them to long for the endless immensity of the sea.” We hope that through our leadership summit and the continued support of the STARS learning network, the medical students who attended last weekend are inspired to lead from where they stand, lifting us all up toward our shared purpose of ensuring the best care for and with our patients.