Speakers Offer New Paradigms for Future Academic Med Centers

Newswise — America's academic medical centers need to institute major changes in the way they train new doctors and medical personnel.

That was one of the major conclusions offered by national experts at a health care symposium last week sponsored by the University of Kentucky. The symposium was attended by more than 500 people.

"Health Care Delivery in the 21st Century" featured lectures by Dr. Jordan J. Cohen, president emeritus of the Association of American Medical Colleges, Dr. David M. Lawrence, chairman emeritus of Kaiser Permanente, and Sue T. Hegyvary, dean emeritus of the University of Washington School of Nursing and alumna of the UK College of Nursing. Highlights of the lectures included:"¢ Changing medical college curricula to emulate student-team approaches used by colleges of business and engineering. "¢ Relying more on computer and mannequin simulations for training."¢ Expecting health care profession students to demonstrate competence rather than assessing them based on fact regurgitation. This includes developing comprehensive clinical skills rather than focusing on the ability to perform physical exams."¢ More inter-disciplinary care along a continuum as the industry moves away from the traditional private-practice approach.

The symposium was part of a series of events celebrating the groundbreaking for a new hospital at the University of Kentucky. The first phase of the new $450 million facility, which will incorporate teaching and research as well as patient care, is expected to be completed in 2011. It is part of a long-range plan to build a more than $2 billion "medical campus of the future" that includes new research and classroom buildings to provide an inter-disciplinary environment for medical education.

Dr. Jay Perman, dean of the UK College of Medicine and vice president for clinical affairs, said of the new facility, "Within these walls we will innovate. We will find better ways to deliver and provide access to health care; better understanding of the mechanisms of human disease; better ways to treat illness " all the while ensuring superior and respectful care to each patient we treat."

Cohen said the American health care industry is facing major changes in patient needs and expectations. While physicians and other health care professionals have provided episodic care seeking to cure a present disease, they must adapt to providing continuous care to preserve health.

Cohen said health care professionals must shift from viewing health situations reactively to becoming prospective " "trying to prevent illness. This is an entirely different mindset for physicians," he said.

Health care professionals are seeing a time when patients have greater expectations about their relationship with providers, he said. Patients have more access to health, disease and treatment information than they have in the past, a situation that will require doctors, nurses and other professionals to build "partnerships" with the patients and their families.

Academic medical centers also will need to build partner relationships with colleagues and facilities in remote locations. These ties to local community-based health care professionals will foster a more seamless approach to providing care, he said.

Lawrence said five forces will shape the future of the industry: science and technology, demography, globalization, consumer expectations, and shortages of health care professionals and capital.

"We are going to be driven in the 21st century, as we were in the 20th century, by the pace and scope of technological development," said Lawrence, who also is an alumnus of the UK College of Medicine.

"We'll see the end of the 'job shop' for most kinds of care," Lawrence said, referring to a likely decline of private practices.

Lawrence agreed with Cohen that patients will become more involved in health care decisions. "Far from seeing himself as a patient, he sees himself getting the information he needs to make an intelligent choice," he said.The industry also will need to be agile to adjust to innovative approaches developed by entrepreneurs to provide lower-cost solutions to expensive treatments.

Physicians " who traditionally have been encouraged to be independent and have embraced that independence " will need to become more collaborative. "For the doctor, the future of effective practice is interdependence "¦ There's much to be learned in how we solve problems together," Lawrence said.

That collaborative approach to practice will need to be instilled during medical school, he said. "We have a great deal to learn from business schools, engineering schools and graduate schools that train people to work together to solve problems. Health care professionals need to learn how to work in a team," Lawrence said.