Reporter December 2002 Home

113th AAMC Annual Meeting: Leadership Forum Examines Trends, Future Opportunities

Plenary Speakers Address Challenges, From Bioterrorism to Health Disparities

Roundup from San Francisco: AAMC's 113th Annual Meeting Notes Trends, Concerns, Solutions

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Managing Editor Scott Harris sharris@aamc.org Staff Writer Elissa Fuchs efuchs@aamc.org

113th AAMC Annual Meeting: Leadership Forum Examines Trends, Future Opportunities

Keynote speakers at the AAMC's 113th annual meeting in San Francisco last month told their audience they see both challenges and opportunities ahead for academic medicine and the nation's healthcare system. Speaking at the meeting's leadership forum Nov. 10 were AAMC President Jordan J. Cohen, M.D., Ralph Snyderman, M.D., outgoing chair of the AAMC, and NIH Director Elias Zerhouni, M.D. Incoming AAMC Chair Theresa Bischoff, president of NYU Hospitals Center, presided over the forum.

AAMC President Jordan J. Cohen, M.D.

Dr. Cohen opened his address, entitled "Who Can You Trust?" with the observation that while research suggests that patients have not lost trust in their individual physicians, public-opinion surveys over the years have documented a continuing erosion of trust in the medical profession as a whole by the public at large.

Consigning this trend to the abuses of managed care, the highly publicized actions of "a few bad apples" in the medical profession, and the growing awareness of financial conflicts of interest in clinical research, Dr. Cohen warned that unless such trust is regained, the public and its elected officials will soon saddle academic medicine with onerous external oversight and regulatory burdens.

To avoid losing the privilege of self-regulation, Dr. Cohen enjoined the medical community to commit themselves to making the delivery of healthcare services safer by enacting a concerted effort to:

• root out medical errors;
• change the culture of graduate medical education by complying with new resident duty-hour limits;
• manage conflicts of interest in clinical research;
• restructure the healthcare delivery system into one that is proactive rather than reactive; and
• prepare new physicians to effectively deliver services in a healthcare environment transformed by the genomic revolution and advances in information technology.

Dr. Cohen concluded by urging academic medicine's leaders to sustain the professionalism that preserves medicine as a moral enterprise. "Competence, patient advocacy, maintaining confidentiality - all these are important aspects of professionalism, but it is trust that lays the foundation for all the rest," he said.

'Prospective medicine'

Outgoing AAMC Chair Ralph Snyderman, M.D.

Outgoing AAMC Chair Ralph Snyderman, M.D., president and CEO of Duke University Health System, outlined his vision for "Prospective Medicine," in which new knowledge about individuals' susceptibility to specific illnesses will allow physicians to take a proactive approach to health care that contrasts sharply with today's reactive model.

Comparing the current age to historical periods in medicine marked by major transformations in healthcare delivery, he noted advancements in new fields such as genomics, proteomics, and medical informatics have the potential to fundamentally change the practice of modern medicine.

Far from being a futuristic vision of medicine, prospective health care is possible today, Dr. Snyderman said, if physicians embrace and uphold the concepts of long-term individual health-care plans, integrated teamwork in the delivery of care, patient education, and ongoing patient interaction and monitoring. To begin accomplishing this, Dr. Snyderman recommended the formation of the "AAMC Institute for Prospective Health Care," which will use academic medicine as the lens through which the practice of prospective care will be developed and nurtured.

NIH director sees gains

NIH Director Elias Zerhouni, M.D.

Characterizing the AAMC as the National Institutes of Health's (NIH) "No. 1 partner," NIH Director Elias Zerhouni, M.D., rounded out the Leadership Forum by reflecting on how changes in the health sciences and America's demographics are affecting the medical research enterprise.

He discussed the dividends NIH investments in academic medicine have paid in terms of the millions of lives saved through research made possible by grant dollars. He noted that the doubling of the NIH budget will make possible new research into the top emerging health threats, such as infectious disease, obesity, diabetes, and bioterrorism.

Dr. Zerhouni also told the audience that the complexity of the biological sciences recently made evident by advances in genomics will require new research on a scale we have not yet seen. The deciphering of such complexity will necessitate the joint efforts of scientists in many different fields who will need to overhaul the current clinical research enterprise in their quest to study disease at the cellular level.

In their search for cures, these multidisciplinary teams, he said, will encounter "the most complex problems ever faced by mankind….The opportunities for a revolution in the biomedical sciences have never been better, and the challenges have never been greater," Dr. Zerhouni said.

By Barbara A. Gabriel

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