Abraham Flexner and the roots of interprofessional education.

This paper explores the culture underlying the practices of physicians and other health care providers in the 20th century and implications for interprofessional education for collaborative practice in the 21st century. Today's practice of medicine flows from the 1920s work of Dr. Abraham Flexner recommending that North American medical schools introduce rigor and consistency in teaching, moving them from private, for-profit, somewhat ad hoc institutions to university affiliation employing physicians dedicated to teaching and research. The education of physicians and other providers was transformed by Flexner's work. However, a sequela has been the "stovepiping" of professions, in both their education and their practices, with minimal interaction among professions, and provider- or system-centric care rather than patient-centric care. The result has been learning environments that lack sympathy for interprofessional education and its concomitant of learning and working together.