This year’s meeting of the Alliance for Continuing Education in the Health Professions, held in January in San Francisco, pushed beyond the usual comfort zone of evidence-based medicine and performance-improvement CME—though there was plenty of that as well—and into some of the edgier territory where speakers appeal to the heart and soul as well as the mind. The message of where healthcare—and healthcare continuing education—has come from and needs to go played out on the main ballroom stage, where the plenary speakers began with a tweak to the Alliance’s traditional call for change, to an embodiment of what that change might look and feel like for healthcare providers and for those who educate them.

The Need for Change
The meeting began with a plenary by Ed O’Neil, PhD, owner of the healthcare leadership and strategy development firm O’Neil and Associates, who explained that, while Abraham Flexner’s healthcare paradigm was progressive for its time, that was more than 100 years ago, when the biggest healthcare challenges were a haphazard medical education system with loose standards and no real regulation to ensure quality.

His Flexner Report helped to professionalize physicians by basing their education on scientific practice and research, ensuring medical schools were autonomous, and requiring stronger state licensure regulations. “In his world, this is what was needed,” O’Neil said.

But now the Flexnerian pendulum has swung too far, said O’Neil. The knowledge that used to define the professions has created autonomous silos so that knowledge no longer flows freely to all who need it. Today’s healthcare consumers, tired of being powerless over their own care, are becoming more actively engaged.

To meet today’s needs, we must integrate the current silos, develop collaborative practices, engage communities, integrate physical and mental healthcare, focus on the patient, and create “radical efficiencies in resource use.” And yet today’s healthcare providers do not want any disruptions to the Flexnerian pattern they are used to. As O’Neil said, “You can object, but it doesn’t matter. It’s going to happen ... Resistance is futile.” But it doesn’t necessarily have to hurt. O’Neil likened the change-resisters to Sisyphus, whom he said fell in love with the rock he was eternally consigned to roll up the hill. “He didn’t realize he could step aside, let the rock hurtle down, and go home.”