In the times bygone, people went to healers for relief from their sufferings. The art and science of healing has been evolving over theyears. From a simple patient-physician relationship, medicine has evolved into complex and adaptive health systems. As the science of medicine advanced rapidly, physicians needed pharmacists to dispense drugs, nurses to take care of ill patients to recovery, dieticians to advise on diet, physiotherapists to manage disabilities, technicians to handle technology, medical assistants to assist physicians in patient care, nurse practitioners to unburden certain functions of physicians, research assistants to assist in clinical research, and counselors to help patients on their road to recovery. Community health workers came into being in response to the shortage of physicians in rural areas and primary care settings.
Physicians undertook personal health management.Health systems, however, needed public health professionals to manage population health and global health professionals to manage global health. Healthcare provision evolved from physician visiting patient’s home or vice versa into a complex system of healthcare provision involving clinics, hospitals, nursing homes, diagnostic centers, pharmacy outlets, rehabilitation centers, palliative care facilities, ambulatory care facilities, ambulances, homecare, and telemedicine.
As provider systems became more and more complex, we needed healthcare management professionals. For-profit private provider systems needed business management professionals. As systems became complex, health information flow became vital to bring harmony and coordination within these systems. As information technology evolved, we needed health informatics professionals to be the bridge between medical, management, and computer science professionals.
As societies advanced, health of people became a public responsibility. In the beginning, governments became responsible for providing health services to their people. As the cost of healthcare kept growing, public health systems got bifurcated into provider and payer systems. The latter has been further evolving into social health insurance, public health insurance, community-based health insurance, and private health insurance systems. Hence, we needed professionals for health insurance management.
As governments fell behind their obligations to provide healthcare for all, private provider systems (public and private, formal and informal, modern and traditional, hospital-based and community-based etc.,) mushroomed across the world to cater to the unmet healthcare needs of the people. With these evolutions, governments needed to offer leadership and stewardship to harmonize the entire health system to make them well functioning. We needed health administrators trained in good governance skills and with a thorough understanding of complex health systems.
While human resources for health evolved into a multiple array of health professionals, health professional education and regulatory systems have not kept up with these developments. Presently, well-defined educational councils exist for medical, nursing, dental, and pharmacists. However, education of other health professionals has been evolving in an unregulated fashion leading to huge variation in the quality of resources generated. It is time to bring the education of diverse health professionals under an umbrella organization in order to ensure uniform quality of health professionals, thereby strengthening one of the core building blocks of health systems, that is the health workforce.
Dr. Krishna Reddy Nallamalla
Country Director, ACCESS Health International
Opinions expressed are personal.