Research funding cuts and smaller profit margins for clinical care are just two of the many critical problems threatening academic medical centers in the U.S. In this break-out session for the U.S. News Hospital of Tomorrow conference led by U.S. News health editor Avery Comarow, panelists addressed the problems facing AMCs and in looking forward, how AMCs must adapt to cut costs while also improve care.
Dr. Victor J. Dzau, President and CEO of Duke University Health System and Chancellor of Health Affairs at Duke University; Dr. Ora H. Pescovitz, CEO of the University of Michigan Health System and Executive and Vice President for Medical Affairs at the University of Michigan; and Dr. Robert C. Robbins, President and CEO of the Texas Medical Center, were the panelists.
Here are the highlights:
Dr. Pescovtiz of the University of Michigan Health System focused on the following key points:
- “Healthcare reform is necessary and is overdue. This is a time of real change and great opportunity and it’s time that we really need to build on our national healthcare system.” AMCs must be “more effective, more efficient, more affordable and more accessible.”
- AMCs are vital. “We are the place patients come for not only primary care, but also for advanced medical care.” “We provide critical patient services [and] 41 percent of all hospital charity care.”
- AMCs are not used to working on a budget. So the system has to be changed from “fee-for-service to population management.”
- Cost pressures shrinking research funding notwithstanding, basic discoveries must remain a key principle of AMCs. “If we forego our supremacy as a nation in basic research, we will give up what is most important as a nation and as academic medical centers.” “I believe strongly in the merits and purpose of research and it’s something that only academic medical centers can do.” Yet, “the government isn’t the only place that is able to fund it.” Funding sources must be found elsewhere.
Dr. Victor J. Dzau of Duke University named five key issues that must be addressed for the future of AMCs. They are:
- Redefining the mission: “We need to define why we do what we do.” “I think we’re really creating academic health systems.”
- Research: “We not only have to look at the genome, but we have to say how what we do effects the population.” Now, the discussion must be from “bench to bedside to population.”
- Education: “What are we trying to accomplish with education?” Education must build inter-professional, social and “team-based learning” skills.
- Organization: There is a “need to create linkers and connectors.”
- Financing: “How do we finance our organization? How do we support the academic enterprise?”
Dr. Robert C. Robbins of the Texas Medical Center said that AMCs need to use their brands for leverage. In addition, “not only should we have collaboration along our team, but we also need to partner with each other.”
Robbins also emphasized the importance of stressing quality over volume. “It’s oftentimes that heart surgeons get promotions because they’re busy and they make the most money.”
“I think that’s something that’s going to change,” Robbins added.
In answering questions, the panel discussed the future of research at AMCs and how teamwork must be incorporated within both medical research and clinical work.