Are we adequately exposing health professions students to the management of disability and chronic illness in the home and work environment ?

The value of long-term supports and services for the 145 million Americans managing chronic illness and disability exceeds $1.3 trillion annually. This is far higher than any other facet of healthcare. Most long-term care happens in patient’s home and work environments. Sixty million volunteer caregivers provide forty billion hours of care annually. The need for this care is growing rapidly.

In spite of these facts, data collected in an electronic mail survey sent to 1,200 graduate health professions schools in the United States shows most students in the 108 responding programs are not exposed to how patients manage their health needs outside of the clinical setting. The majority of students who do see how healthcare is handled at home and work spend less than five percent of their training time on this central aspect of patients’ lives.

 Only 35 of 108 responding programs required student exposure to patient care at home and work. Approximately 40 percent of students at schools with optional or volunteer opportunities to work outside of the clinical setting chose to learn there. Forty-one programs reported no learning opportunities for their students to see how patients manage their health at home and work.

Health professionals’ limited experience of how patients manage chronic health needs at home and work can weaken patient-provider communication and increase healthcare costs due to “real world” health crises rising from complicated and/or mishandled regimens whose practical challenges are underappreciated because practitioners have limited exposure to healthcare outside of the clinical setting.