The “crease” is what I call the interface between the academic world (part of the “knowledge industry”) and the health care delivery world (part of the “health industry”). It is where academic medicine lives and, in my opinion, misunderstanding of that fact is the root cause of many conflicts between medical schools and their clinician faculty, and the teaching hospital. Those conflicts arise when medical schools and teaching hospitals seek individual greatness for the clinical and academic enterprises rather than greatness for the academic medical center in which they are inextricably intertwined. I stress, “inextricably intertwined.” Nearly everything done in the academic medical center, whether teaching, research, or clinical care, is a “joint product” created through inseparable efforts and components.
Americans pay more for their health care than residents of other high-income countries, but have greater health disparities and worse health outcomes. Singapore ranks sixth in the world in health care outcomes, well ahead of other developing countries, while spending significantly less than other high-income countries. William Haseltine, chairman and president of ACCESS Health International and author of Affordable Excellence: The Singapore Health Care System, attributes Singapore’s ability to control health care costs to balancing a highly regulated market and managing a successful social wellness program.
In my last blog I addressed the need to create a culture of health in communities across America as one of five key actions that will help achieve the Triple Aim of better health, better care and lower costs. Revitalizing and growing primary care is a second key action to achieving truly sustainable health care reform and helping reduce the medical cost trend.
Dr. Joanne Conroy, chief health care officer at the Association of American Medical Colleges, explains the name of this blog on the site’s home page:
“Academic medical centers and teaching hospitals are at a crossroads in redesigning our health care system and examining how they educate medical professionals … They are constantly engaged in building the next Wing of Zock as they seek to define a future that signifies hope.”
We have a new department in the School of Medicine at the University of Missouri–Kansas City (UMKC) that resulted from our own examination of how we educate medical professionals. The Department of Medical Humanities and Social Sciences is the result of the need we felt to create new avenues in the education of medical professionals. We were fortunate that Betty Drees, Dean of the School of Medicine, saw the value of focusing attention and resources on this area, which complements and enhances the basic and clinical sciences.
Readers, my name is Jeet Guram. I am honored to join this blog with Avik and such a great group. I just finished my third year of medical school, which students spend in an academic hospital as a member of clinical teams caring for patients. Leading these teams are “attendings,” or fully certified physicians. In between medical students and attendings are “residents,” who have completed medical school and are training in a particular field. Non-academic hospitals usually do not have medical students and residents. Continue reading →
This past week I attended the Canadian Association of Emergency Physicians annual conference in Vancouver. I agree with the conclusions made by Brent Thoma, Chris Bond and Ken Milne who have already reviewed the meeting here, here and here. Instead of going over many of the same highlights, I want to explore a more fundamental question.Should medical students attend academic conferences? It all started with the below twitter conversation between a few of my professors that came across my feed while I was out at #CAEP13.
@rvanwylick Does Star Wars conference count? — Michael J Sylvester (@mjsylvester) June 3, 2013
We: 1. Didn’t know anything about them. 2. Could not afford to go. 3. Likely were not expected or invited. Times have changed. — Richard van Wylick (@rvanwylick) June 2, 2013
@mcg_meded Hmm. Maybe somebody should study: 1. Has it really changed. 2. How do students benefit from going (or do they?)?
This conversation deserves more than the 140 characters that twitter permits, so here is the forum for that discussion. In this post I will point out a few of the benefits and drawbacks for medical students attending conferences based on a bit of my own experience and some literature. I hope that it provides a jumping off point for some good discussion around the topic. Continue reading →
Medical schools and institutions have the most remarkable intellectual property within their staffs—but no one ever sees it. Doctors sit quietly in their offices with their ideas and experience. Marketing professionals work to try to find the material and the differentiators that can publicly define the institution. Patients look for cases and stories that may match their own. Medical students seek experience and real world know-how.
The trick is to get that information and wisdom to places that can do good: public places.
The Wing of Zock staff recently sat down with Meg Keeley, MD, Assistant Dean for Student Affairs at the University of Virginia School of Medicine, to discuss learning communities and the beneficial role they can play for medical school students.
Learning communities have existed for many years at colleges and universities, but are a relatively new phenomenon in medical schools. By dividing larger classes into more intimate groups, as well as adding supports, these communities help students make meaningful connections with faculty and peers, and improve the quality of the learning experience.
There are a variety of learning community models, including curricular, wellness, and advising. Many medical schools are moving toward a hybrid model that combines clinical learning, advising, and social components (think of the Hogwarts Houses in the Harry Potter series).
In this video blog post, Dr. Keeley shares her views on how learning communities can be integrated into the changing world of academic medicine and tells us about the Learning Communities Institute (LCI), a professional group supporting all of the different learning communities at med schools across the United States.
To learn more about learning communities and the work of the LCI, please visit them on Facebook here.
It’s graduation season, and I had the privilege of giving a medical school commencement speech this month. New M.D.s head into their residency programs facing a changing health care system and an exploding population of patients, many of whom will be getting insurance coverage for the first time. The challenges new physicians face will be shaped significantly by lawmakers and the proposals they are putting forward to solve the nation’s fiscal crisis. All of these forces coming together make it imperative for tomorrow’s physicians to be active and engaged, not just on health care issues, but on behalf of the patients they serve.
Lower-cost healthcare options such as retail clinics and a decline in hospital readmissions are holding the projected increase in medical costs to 6.5%, a full percentage point lower than the 2013 projected rate, says PwC's Medical Cost Trend report.
Two of the pioneering forces behind accountable care organizations say the model is gaining significance as it proliferates across the country, even though there are concerns over lack of uniformity in performance measures.
Data from the American Medical Association details the costs of medical billing complexity on patients and physicians, who are put "in the awkward situation of having to ask patients for money," says an AMA board member.
Stakeholders, including representatives from the Healthcare Financial Management Association and the American Hospital Association, have drafted new best practices for providers to communicate with patients who are becoming increasingly responsible for a greater proportion of their healthcare costs.
Most of the proposal focuses on program integrity for state marketplaces and insurance companies offering coverage in the federally facilitated exchanges. The rule intends to safeguard federal money and consumers.
Life in the “Crease”: Academic Medicine–Where the Knowledge Industry and the Health Industry Meet
The “crease” is what I call the interface between the academic world (part of the “knowledge industry”) and the health care delivery world (part of the “health industry”). It is where academic medicine lives and, in my opinion, misunderstanding of that fact is the root cause of many conflicts between medical schools and their clinician faculty, and the teaching hospital. Those conflicts arise when medical schools and teaching hospitals seek individual greatness for the clinical and academic enterprises rather than greatness for the academic medical center in which they are inextricably intertwined. I stress, “inextricably intertwined.” Nearly everything done in the academic medical center, whether teaching, research, or clinical care, is a “joint product” created through inseparable efforts and components.
Continue reading →