Interview with Meg Zomorodi on How to Change Medicine in Rural America and Beyond
Meg Zomorodi directs the Rural Interprofessional Health Initiative at the University of North Carolina, Chapel Hill. The program trains future medical professionals to work and practice together in rural America. She spoke with The Philanthropy Roundtable about the importance of interprofessionalism, what doctors can learn from business school, and how to prepare students to work in different cultures than the one they grew up in. The interview has been edited for length and clarity.
Davis: How is interprofessionalism defined? Does it just mean “working together”?
Zomorodi: For schools to maintain their status as accredited schools they have to show evidence of interprofessional education. It’s a very specific definition that they have to meet: “When two or more professions come together to learn from, with, and about each other.
It can’t just be me as a nurse going into a classroom of medical students and teaching them because that’s learning from me. They actually have to learn with other professional students, learn from each other, and then, most importantly to me, it’s the learning about. It’s what makes us understand why we each do what we do.
Davis: What are interprofessionalism’s benefits?
Zomorodi: I ask folks to think if they’ve ever been in the hospital themselves or had a loved one in the hospital. That’s pretty much everybody. From the time they came into the hospital to the time they leave, think about the number of hands and the number of roles that touched their loved one or engaged with them in some way. It’s a lot of hands.
Imagine if those hands didn’t know how to work with each other; they didn’t know how to talk to each other; they didn’t know how to engage. In reality, we don’t teach students that. We teach them in their silos. And then we expect them to suddenly, magically know how to work and talk to each other. And there’s power and hierarchy and culture that all goes into play with that. Thinking about how we can break those silos down and engage them earlier to change their biases is what we’re trying to do.
Davis: Do you have every school involved at the university?
Zomorodi: Since it’s an accreditation requirement for the health professional schools, we began with the health professional schools. But we didn’t want this to just be accreditation focused. We wanted to advance health and think about doing this on a global scale rather than just because we have to.
Thinking about where health goes wrong, one of the key pieces is your educational and socioeconomic status. K-12 education is foundational for your health. There are actual studies that say if you do not invest in K-12 education, those individuals will be less healthy than those who are more educated. And so, the school of education seemed like a huge partner for the work that we are doing to advance the health of populations.
Davis: What does the business school contribute?
Zomorodi: There’s a business of health care that’s important: the amount of cost that we put into our health care system, the focus on outcomes-based care. That’s definitely an aspect of it. But then there’s this focus on organizational change and leadership that the business school can bring.
We have been so fortunate here to have an amazing colleague in the business school who has helped us think about relational leadership. We can actually work together in an authentic and generally curious way, and by working together, we can further break down those silos. I can teach all day long why it’s important, but actually giving them the skills to be able to practice that leadership and be the culture change of what we want to see is important.
Davis: Is there another component?
Zomorodi: The third bucket is really thinking about healthy communities. When we think about healthy communities, one of the needs we know is more docs in those spaces or more PAs, nurse practitioners. But it’s also retaining them and keeping them there. The way you do that is building up the economy of those rural spaces. We need the business school to help us think about that.
Davis: Your students travel to rural areas to do an extended practicum. How does that work?
Zomorodi: They get seminars and training to team build and teach them how to work together. They go through a series of seminars to prepare them for how to engage in a community effectively. It can’t be just “I’m the big bad student coming in and then I leave.” It has to be an intentional relationship.
We talk about what the strengths are in a rural community, and there are so many—like human capital, resiliency. Anybody who has seen a hurricane knows the rural communities, they’re resilient. The seminars happen usually for about two semesters with pods of students who are working together. Then they spend their summer in that community doing a needs assessment, finding out how they can help that community. They live in a house together and work.
And then, they come back—so, that’s the third semester. Then their fourth semester they actually work on a quality improvement project and give back to that community. And that begins in that summer work because they’re assessing. And then they move into actually, “What can be done?” Our next cohort picks it up and carries it further, so we have a longitudinal relationship with that community.
Davis: If a philanthropist came to you and wanted to encourage interprofessionalism through medical education, what strategy would you recommend?
Zomorodi: Maybe the strategy is thinking about funding from a systems level rather than one individual kind of project. When that project ends, what happens? If we make systems change, it’s going to be hard, it’s going to be long, and it’s going to be lots of people, but the return on that investment might be very, very different.
Davis: Could increased interprofessionalism help broaden the pool of those people who become doctors?
Zomorodi: I think it might help them find the profession that they were meant to be. Because it could go the other way: “I always wanted to be a doctor because that’s what I thought I needed to be, but in reality, I’m finding that I am amazing being an occupational therapist. That’s my calling.”
Having an awareness of each other’s roles might actually give us better happiness because we’re finding where we need to be.
Alysa Davis was the health program coordinator at The Philanthropy Roundtable from March to December 2020. She now serves as an office management specialist for the U.S. Foreign Service. To read the rest of this series, click below.
Part 1: Teaching Doctors Virtue
Part 3: Grading Medical Schools
