By Marna Borgstrom
We have seen significant changes in health care with the passage of the Patient Protection and Affordable Care Act (PPACA) almost two years ago. However, the most challenging part of our work is truly just beginning. To ensure that we play an essential role in the evolving health care market, academic health center providers must take the lead by tackling the difficult issues of changing a deeply-embedded individualistic culture, and move towards improved alignment within the academic and clinical enterprise.
As leaders of organizations training much of the future health care workforce, all eyes are upon us. We cannot afford to throw this opportunity away; we must embrace it and demonstrate we can effect sustainable change. Recognizing and mitigating the dissonance between components of the academic and clinical cultures should be a priority at our institutions. At Yale New Haven Hospital, we are working to do this by implementing a system-wide cultural integration initiative among the health system members and our partners at the Yale University School of Medicine to define and align the current and desired cultures across our organizations.
We must find clarity and alignment between and among our missions and business imperatives to develop a sustainable funds flow. Finding harmony between the academic model of medical schools and the evolving market model in which academic health centers operate is critical in order for us to affirm our value. We are no longer in a position to keep the business and academic models separate and isolated.
We must better relate the vital roles of medical school-based research and teaching to the creation of an innovative, sustainable future healthcare workforce providing evidence-based affordable care. We must better-articulate the role of graduate medical education (GME) in enhancing the care we provide. We must define that which distinguishes us most and adds value to the populations we serve, and be prepared to discontinue activities and services that don’t.
The clinical enterprise needs to be great in order for the academic enterprise to operate with distinction and vice versa. Leaders at academic medical centers must seek common ground in order to fully align our business models and our culture.