Much as it is with the nation’s overall healthcare system, the survival of academic medical centers (AMC’s) is threatened by a combination of economic, cultural, and demographic factors. If AMC’s are to survive to fill their societal responsibilities, they must adopt a new philosophy. Challenging assumptions and providing the shift in perspective that a resolution of this crisis requires, Arthur Feldman PhD, MD provides us with a thoroughly researched and forward-thinking volume that all those concerned with healthcare must read.
This brilliant manifesto will help physicians, policymakers, analysts, and regulators understand the challenges faced by today’s AMCs. But more importantly, Pursuing Excellence in Healthcare: Preserving America’s Academic Medical Centers offers a cogent, viable plan that will reestablish the leadership role that AMCs need to play in providing Americans with the best possible care.
Table of Contents
SPHERE OF ACTION 1: STRUCTURE
Integrating the Diverse Structures of the AMC
Integrating Clinical Care Delivery Systems
Leadership in the Academic Medical Center
SPHERE OF ACTION II: RE-SEARCH
Fixing the "Broken Pipeline" of AMC Scientists
Resolving Con1licts ofInterest
Commercializing Research Discoveries
SPHERE OF ACTION III: EDUCATION
Resolving the Physician Workforce Crisis
The Changing Demographics of America's AMCs
Teaching Medical Professionalism in the AMC
SPHERE OF ACTION IV: BUSINESS
Financing the Missions of the AMC
Developing Strategic Regional and Global Collaborations
Insuring Governmental Support and Oversight of the AMC
"This is a terrific resource for anyone interested in understanding the indispensable role of the academic health center. But this is not an apologia. Dr. Feldman identifies the key problems we need to solve and the kinds of solutions we must adopt to ensure the excellence of our essential missions in research, training, and health care going forward. A book all health care leaders should read and then read again."
— Michael M.E. Johns, Md, Chancellor, Emory University
"You will not agree with everything that Dr. Feldman writes in Pursuing Excellence: Preserving America’s Academic Medical Centers, which is precisely why you should read and debate it. Scientist, scholar, educator, entrepreneur, and, especially, clinician, Dr. Feldman has given us a provocative and passionate insider’s view. It arrives just in time to stimulate our thinking at this moment of great opportunity."
— Andrew L. Epstein, MD, Managing Director, Navigant Consulting, Inc.
"This is a splendid book that explores the unique role and contributions of academic medical centers in society. Enhanced by the author’s intimate knowledge of the subject matter, it is well structured, easy to read and thought provoking. It details the evolution of academic medical centers from their origins as small, simple enclaves for medical scholars with altruistic motivations to their current form as large, complex enterprises that serve as a home for cutting edge health care, biomedical research and health professional education, and as an economic engine for the communities they serve.
"The author underscores the essential importance of excellence in health care as a cornerstone for most successful academic medical centers and explores the synergistic roles of four elements that he proposes as components or spheres of action of a model for a successful academic medical center: structure, research, education and business. Each is explored in some detail, often benefiting from the author’s knowledge and personal experience. Always based on fact, the author’s passion for the subject matter is ever present and makes this a very interesting book to read. I recommend it for anyone who wants to know about the elements that have shaped and continue to influence the structure and functioning of academic medical centers in the United States. Dr. Feldman is to be congratulated on writing a very important, timely and remarkably entertaining book."
— Paul K. Whelton, MB, MD. M.Sc., President and Chief Executive Officer, Loyola University Health System, Loyola University Medical Center
"This comprehensive overview of the academic medical center enterprise brings together, in a remarkably coherent fashion, history, economics, and politics as they intersect with the traditional academic missions of education, patient care and research. It is informative and perceptive, with substantive insights and recommendations. The book is a welcome addition to the growing literature in this area."
— Steven A. Wartman, MD, PhD, MACP, President/CEO, Association of Academic Health Centers
"Dr. Feldman has done all of us who care deeply about the future of academic medical centers a service in presenting the wealth of facts and thoughtful analysis that he provides in "Pursuing Excellence in Health Care: Preserving America's Academic Medical Centers." Whether one agrees with his final recommendations or not, his arguments are well developed and persuasive, and the important issues are delineated comprehensively and fairly. I was particularly struck by his introductory comment that the four C's that ought to provide the foundation of our work as physicians - compassion, confidence, commitment and competence - are in danger of being replaced by the four A's that define success in the modern healthcare marketplace - affability, availability, affordability and accessibility. I would take this one step further to say that the greatest value of the academic medical center to society likely resides lies within the four I's: imagination, intellect, innovation and idealism. Reading this book may help us to keep it so."
— R. Sanders Williams, MD, Senior Vice Chancellor for Academic Affairs , Duke University School of Medicine
"Arthur Feldman, M.D., Ph.D., has produced a landmark work, documenting the plight of the U.S. academic medical center (AMC), highlighting its importance, and charting a course for securing its successful future. Dr. Feldman appropriately places clinical care at the center or the AMC’s mission and insightfully guides the reader through the labyrinth of interdependencies among the AMC’s essential clinical, teaching, and research missions. He hones in on the complexities of structure and business operations, exquisitely describing how we got where we are, and providing a clear vision for surviving and thriving in the upcoming challenging era. Dr. Feldman’s book is a must-read for all stakeholders in the mission of preserving what is good about US healthcare and fixing all that is broken about it."
— Marvin A. Konstam, MD, Chief Physician Executive, The CardioVascular Center, Tufts Medical Center; Professor of Medicine, Tufts University School of Medicine
"Art Feldman has done a great service to the world of academic medicine by conceptually redesigning the "three legged stool" academic medical center architecture into a thoroughly modern pyramid with academics, business, structure, and research as its base and outstanding clinical care as the apex. The ramifications for AMC leadership effectiveness of acknowledging and embracing this bold revision are profound, as are the accompanying challenges of identifying, preparing, and sustaining such leaders. Dr. Feldman's comprehensive and insightful perspective on the AMC's dilemma in our time not only validates and informs the struggle AMC leaders face but illuminates potential strategies for their success going forward. Kudos!"
— Stephen Blattner, MD MBA, Founding Principal of exăgoMD, LLC, Sponsor of the Health Care Leadership Blog (www.healthcareleadershipblog.com)