History of the Movement
The concept of “social mission” in medical or health professions education in the United States was not much used before 2010.
Approaches to addressing social and structural determinants of health were identified, but no unifying frameworks described the responsibility of training institutions in improving health equity.
The Start of the Movement
The first Beyond Flexner Conference was co-hosted by Gerry Clancy, then president of the University of Oklahoma School of Community Medicine in Tulsa, OK, and Fitzhugh Mullan of GW. Keynote speakers were the former Surgeon General, David Satcher, and Jack Geiger, who is recognized as the father of the community health center movement and a leader in the field of social medicine. Many of the 200 participants at the meeting held important university positions in areas such as diversity and inclusion, rural health, and primary care but often felt marginalized in their home settings. Coming together with a social mission common ground was electrifying. The sense of purpose was strong, and participants left Tulsa reinforced in their missions with new concepts and new colleagues.
The timing of the first Beyond Flexner conference coincided with the implementation of the Affordable Care Act (ACA) and a national emphasis on health care delivery innovation, payment reform, and social determinants of health. Beyond Flexner succeeded in attracting a new generation of supporters, bringing together activists in primary care and service delivery with more established groups in diversity and community engagement – combining new tactics of social media and internet organizing with more traditional approaches to student organizing and curricular reform.
The Growth of the Movement
The second Beyond Flexner Conference took place in Albuquerque, NM in April 2015 and was co-hosted by the University of New Mexico (UNM). The UNM Health Science Center has a rich history of community engagement dating back to the opening of the medical school in 1965.
Two important decisions were made at that conference. The first was in response to the group consensus that inter-professional education for health professions students is essential to quality clinical practice and promotion of health equity in the future. Based on this view, the conference endorsed a change in the name and identity of the movement to “Beyond Flexner: Social Mission in Health Professions Education” with a commitment to broaden the agenda and the participation of nurses, PAs, community health workers, dentists, and others in future Beyond Flexner Conferences. The second decision was to create a formal organization, the Beyond Flexner Alliance (BFA), devoted to promoting social mission in health professions education.
The BFA would have core goals of reducing health disparities, enhancing diversity, advancing community engagement, and using health care resources responsibly. The number of organizations with increasing interest in pursuing social mission (by whatever definition) within health professions education was large and growing. The BFA was envisioned as a common ground that would provide a human and electronic platform for these people, organizations, and institutions as well as an accelerator for their common missions.
In March 2016, after receiving core funding from the Atlantic Philanthropies, representatives of the inter-professional education movement held a strategic planning meeting in which they created the BFA vision, mission, and core concepts and established a 12-member Board of Directors. Fitzhugh Mullan was elected Board Chair, Divina Grossman, Professor of Nursing and Former Chancellor at the University of Massachusetts – Dartmouth was elected Board Vice-Chair, and Leigh Anne Butler from the GW Health Workforce Institute as Secretary/Treasurer. The Board set out to build a communications presence (website, newsletter, blogs, webinars, etc.), a membership strategy, and a business plan. Additionally, they were tasked with overseeing Beyond Flexner national meetings, creating awareness of and recognizing best practices, and exploring additional sources of support and collaboration for the BFA.
From 2016 to 2022, four more national BFA Conferences were hosted by health professions schools known for excelling in social mission, including one virtual conference during the height of the pandemic.