Social responsibility starts with education

Clinicians, more often than not, hold privileged positions in the societies in which they work, and the reasons for this are embodied in the concept of the social contract, a contract between health professions and the society they serve, which originally arose from political science [1].

However, as many of us have been told since childhood, with privilege comes responsibility and within healthcare our day-to-day responsibilities as practising clinicians are many. Yet, in more recent times, in addition to the day-to-day responsibilities routinely associated with provision of healthcare to our patients, the construct of social responsibility has been specifically highlighted as being of importance to healthcare professionals across the globe [2,3]. This almost certainly represents a natural thought progression as we realise that the treatment of individuals for many common conditions is insufficient to improve the health of the population as a whole as long as large health inequalities continue to exist in our societies.

Wider health equity and greater social accountability are important elements in achieving lasting wide-scale health improvements leading to a healthier long-term future for all. Yet this is not a new concept, Tudor–Hart’s inverse care law [4], for example, was published in the Lancet in 1971 – so health inequality has long been recognised as a key consideration for society as a whole and healthcare professions in particular.

Despite a gradual increase in the frequency of appearance of the term social responsibility within the published health professions educational literature, it is uncommon to see two papers with the term in the title juxtaposed in an issue of a journal. Yet our two leading articles in this final issue of Education for Primary Care for 2021 do exactly that, and I recommend both of them as being well worth a read.

Patterson and Blane offer a blueprint of how to strengthen the presence of social accountability and health equity within the training of general practitioners, whilst Khan and colleagues consider the merit of bringing patients’ lived experiences of long term conditions into curriculum design in the hope of ultimately improving provision of holistic, socially accountable care by the clinicians the designed curricula eventually produce.

For me, both of these articles also speak to the wider societal issue that meaningful, beneficial change for all in society almost always has to start with education and, as health professional educators in primary care, we are well placed to help our learners gain many of the skills and tools they need to go out and change the world for the better. To paraphrase the title of a Canadian medical education paper, social accountability really is at the heart of family medicine [5].