There is a tremendous amount of handwringing among students, workforce researchers, and medical school deans about the record amount of debt that medical students incur—more than $175,000, according to the Association of American Medical Colleges. This has unintended consequences, including student selection of more lucrative specialties and placing medical education beyond the reach of low-income and minority students. The average household income for a matriculating medical student is more than $110,000 per year. We must get serious about reducing this debt. A talented medical workforce is a national priority.
By Joanne Conroy, MD
Health care reform is challenging academic medicine to reinvent itself as we seek to sustain our missions of clinical care, education, and research. Although the external world may think we are excruciatingly slow to change, pressing conditions—market consolidation, fiscal pressures facing the acute care enterprise, and payers’ new focus on higher quality and lower cost—are driving the creation of a new operating model for academic medicine. Every aspect of how we do business will change: how care is delivered, how students and residents are educated and integrated into clinical care, how the research enterprise is organized and funded, and how the missions come together in a new and meaningful way.
For the past year, the AAMC Advisory Panel on Health Care has worked to develop guidelines and leadership principles to help AMCs create sustainable models for the future.
The panel’s findings are soon to be released in a formal report, which identifies eight themes common among the vanguard of academic medical centers.
Admit it: You made one or more New Year’s resolutions. Many of you committed to losing weight, working out more, and organizing your life. Any resolution that makes you healthier and happier is great. But have you ever thought about making a resolution that isn’t about you, but about someone else? This year, resolve to create positive impact for those around you.
In case you missed them, here is a roundup of our Top 10 Most Popular Posts of 2013:
1. Proposed U.S. Allopathic and Medical Schools, by James E. Lewis, Ph.D.
2. Matching the Unmatched: The Role of the Medical Student Career Advisor, by Marlene Welch, M.D.
3. The Primary Care Shibboleth: Debunking the Myth, by Robert E. Harbaugh, M.D. (cross-post)
5. How Will We Treat This Generation’s Henrietta Lacks? by Ann Bonham, Ph.D.
6. Health Wonk Review: Rhetorical Question Edition, by Sarah Sonies and Jennifer Salopek
7. Empowered Nurse Advocates Build Effective Patient-Centered Care Teams, by Gloria Ohmart, Ed.D, MN, APRN
8. Time’s Brill Persuasive but “Bitter Pill” Misdiagnoses Health Care Ills, by Joanne Conroy, M.D.
9. Five Topics I Avoid as a Social Physician, by Bryan Vartabedian, M.D.
10. Assessing Med School Applicants’ Digital Footprints, by Bryan Vartabedian, M.D.
I often listen to books on CD during long trips in the car. They’re a great way to catch up on reading and provide the added bonus of letting me avoid the mind-numbing “hit list” of pop tunes on the radio.
After a trip that flew by while I laughed to Tina Fey’s Bossypants (worthy of a future post if I can figure out to link it to health care), I tried another nonfiction selection from my local library: Drive by Daniel Pink. Pink worked as an aide to Secretary of Labor Robert Reich, and from 1995 to 1997, he was chief speechwriter for VP Al Gore. He graduated from Yale Law School and has written five best-selling management books. His 2009 TED talk on “the puzzle of motivation” is one of the 10 most-watched.
If you’re in the luckiest one per cent of humanity, you owe it to the rest of humanity to think about the other 99 per cent.― Warren Buffett
My friend Barb is 58 years old. She was laid off last December by the bank in New York City where she worked. Barb lives in northern New Jersey and has been unable to find full-time work in the 10 months since. She works in a pet store and does any odd job; she works seven days a week just to pay her rent. She is often overwhelmed with anxiety about being evicted. She has no health care coverage and is absolutely terrified.
Yesterday was not a national holiday. It wasn’t Barb’s birthday or her anniversary, but it was a very special day that brought her cause for celebration.
“We cannot solve our problems with the same level of thinking that created them.” ― Albert Einstein
Academic medicine and, frankly, most of medicine is changing how we think about delivering care. The effective, integrated application of knowledge, science, and technology will allow us to finally deliver on the promise of personalized medicine within a framework of population health. But operating within that framework requires that we think differently. We must understand not only the needs of individuals but the broader picture of systems of care and systems-based practice.
For many practitioners, a bundle is either:
- One set price for cable, phone, and TV
- A myocardial conduction system
- A software program that automatically handles formatting, paginating, indexing, and collating of documents into a printable PDF.