Spend any time around the Webb or Scrushy Buildings at UAB and one thing quickly becomes clear : The students and graduates trained within these walls aren’t “related” to modern health care—they’re an integral part of it .
And so the decision was made—after many discussions and much internal polling—to unite under the new name UAB “School of Health Professions.”
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“The change is really indicative of the evolution that has
occurred both within the school and in health-care education in general,”
says Harold P. Jones, Ph.D., the school’s dean. “As the disciplines we teach
have grown more rigorous, we realized it was time for the school’s name to
reflect that shift—recognizing that our graduates are now central players on
the medical team, as opposed to being seen as simply
providing support to their activities.”
While that answer certainly explains the basic truth behind the name change,
a deeper and more complex evolution is at work in the world of health
care—one that began with one man’s dream of a Great Society. |
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Occupational therapist Tosha Gaines works with children at
the Early Intervention Center .
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Access for All
“When Lyndon B. Johnson was laying out his vision, he saw
access to health care as a central issue, so he made federal funds
available for training in a host of related fields,” Jones explains. “The
obvious ones came first, such as medicine, nursing, and dentistry,
but then lawmakers realized there were hundreds of other professions related to health care, and they didn’t want to write bills for every one of them. That’s when the term ‘allied health’ came
into use, with the basic definition being ‘if you don’t belong
to these seven professions, then you’re classified as allied health.’
So you were basically defined by
what you were not.”
Recognizing an opportunity, universities began looking at
what programs they had and where they were housed
on campus. “Sometimes you’d find health administration
in the business school and physician-assistant
studies in the school of medicine, so the idea was to
bring them together to form a new school of allied
health professions,” Jones says. “That was really the
genesis for the creation of these types of schools
around the country, and it was an organizing element
as well.”
Then the definitions began to change. Certain
professions were reclassified as “non-allied health”
programs, which called for some schools to come up
with a different descriptor. As they rethought the issue,
the name most popular in the early days—schools or
colleges of “allied health”—began to lose favor, and
it is now the third most-used name behind “health
sciences” and the leading choice by far, “health professions.”
“I think the new name communicates the seriousness
of what we do, while at the same time it’s a small
enough change that we don’t risk compromising our
identity in the process,” Jones says. “Plus it’s flexible
enough to allow for the continued evolution of the
programs we offer.”
A Collaborative Model
As the first dean of the school once it became solidly established
within the university, Keith D. Blayney, Ph.D., had a front-row seat
at the leading edge of that evolution. “When the school was established—
with the help of a Kellogg grant and funds provided by the
School of Medicine at UAB—it was called the School of Community
and Allied Health Resources,” he says. “But we didn’t have any
resources, so we changed the name to the School of Community and
Allied Health.”
The school then became involved in the Appalachia Program,
which focused on the public-health needs of three
northern Alabama counties, eventually completing a health-needs assessment of 47 of the state’s 67 counties. This spurred yet another change—to the School of Public and Allied Health—made to reflect the school’s growing involvement with public health. UAB’s School of Public Health, in fact, originated within the allied health school before it became a freestanding entity.
With additional funds from the Kellogg Foundation, Blayney
also oversaw the establishment of the Regional Technical Institute
Linkage Program, or RTI, which forged a bond between the school and the state’s community colleges. “Students
would complete the first year of their training at the community
college and then transfer to UAB for the remainder of their studies,”
he says. “They received their associate degree from the college and a
certificate for whatever allied-health field they were entering from us,
and this worked very well for a number of reasons. The first is that
the state didn’t have the funds to support programs all over the state,
so thousands of dollars were saved in that way. Plus the students
saved money because they were paying junior-college tuition rates.”
The program was so effective that the Kellogg Foundation wrote
it up as a national model—and one of its most successful funding
ventures—in one of its reports. While the nature of the relationship
between the school and community colleges has changed over
time, Blayney says that “about 10,000 students graduated from the
program during its period of operation, and they went back to their
home communities for the most part, so the overall goal of introducing more health-care professionals into underserved areas was achieved.
Academic Evolution
Still, one tradition—the formal relationship between community
colleges and the school—was discontinued in the early 1990s.
While the reasons for this were numerous, it primarily had to do
with the fact that the degrees being awarded in certain disciplines had begun to shift, and the junior colleges decided to develop training programs of their own.
Stephen N. Collier, Ph.D., a professor and director of the Office
of Health Professions Education and Workforce Development, was
in charge of the RTI program during the 1980s. He sees the
program’s demise as a result of a natural evolution within the structure of health-care training programs. “Over the years we’ve seen certain professions begin to clarify themselves and rise to a higher level of academic instruction,” he says. “A good example would be physical therapy, where a P.T. assistant is still trained at the associate-degree level while a physical therapist would pursue a master’s degree or their doctorate, which is a D.P.T. in this instance. And since we’ve never really offered an associate degree—just a certificate in conjunction with an associate degree awarded by a community college—it just makes sense that each of us focuses on our particular strengths.”
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And as part of a major medical teaching and research institution,
SHP is particularly well suited to adapt to the rising demands placed
on its graduates. “When you look at occupational therapy or hospital
administration or physical therapy—among others—you’re seeing
fields that are definite and legitimate professions, with graduates
going into private practice or remaining within academia. And the
faculty within those disciplines are generating significant research of
their own,” Collier says. “Not only are they consuming more of the
material, they’re contributing to that body of work as well.”
Dean Jones provides an interesting insight into this development: “Many of
the so called ‘allied-health’ professions grew up at the bedside,” he says,
“where
people basically acquired their skills as an apprentice to a practitioner.
So what we have are fields that have migrated from the clinical into the
academic environment, rather than the other way around. In light of
this, it just takes a little |
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Brookwood Hospital COO Joe Stough is one of many bright
stars to graduate from SHP’s Health Services Administration Program.
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time to begin building up a faculty base who are involved in what are
viewed as ‘credible’ academic pursuits. Take a field like philosophy,
which has been around for thousands of years in the academy, as
opposed to something like physical therapy that has only existed in
an official capacity for the past 40 or 50 years. That makes this a very exciting time for us. As these fields grow and develop, we must keep up with what’s required from an educational standpoint.” |
Responding to Change
And those requirements are rising with each passing year,
according to assistant dean Claire Peel, Ph.D. “We’ve seen a real
increase in the responsibilities our graduates are encountering in
the workplace, and we’ve had to elevate our training methods in
response to that,” she says. “These increased responsibilities are due
to changes in health care, where sicker people are being sent home
or to outpatient clinics sooner, so the professionals who take care of
these patients really must possess a high level of skill.”
Another of these changes has to do with the development of a
team approach to providing health care, instead of placing most of the weight on the physician’s shoulders.
“These days you’ll often find that when
a patient asks their doctor what they can
do after surgery from a physical standpoint,
the physician will often defer to
the physical or occupational therapist.
And we also have physician assistants
and others coordinating care, so there is
much more of a team-based effort in the
clinical setting, with the patient being
the center of the team’s focus.”
Even beyond the evolution of existing
fields, new disciplines such as genetic
counseling are emerging, which Peel sees
as a natural fit for the school. “We’re currently in talks with the Department of Genetics to collaborate
on a master’s-level training program, so that’s something we hope to
introduce in the next couple of years.”
The point is that the School of Health Professions is a vital
enterprise that continues to evolve and define its purpose, Peel says.
“I think there was a time when ‘allied health’ was viewed as providing
ancillary services, and I believe the message we’re now sending is
that we are providing high-level training to graduates who are really
making a difference in health care.”