AAMC Reporter: December 2004

AAMC Annual Meeting Highlights Political Season

AAMC members were encouraged to embrace change and increase diversity in healthcare during the organization's 115th annual meeting in Boston. Prominent guest speakers provided analysis of the recent election and its implications.

In keeping with this year's theme, "Fulfilling the Promise," AAMC President Jordan J. Cohen, M.D., urged members to create a culture that embraces change to ensure that high levels of education, research and patient care are maintained in academic medical centers. He pointed, for example, to the need for more teamwork within institutions as a method to accomplish this task.

"Organizational structures and decision-making processes are the products of people, and, in theory at least, these obstacles to change can be minimized once vested interests are convinced there is more to be gained than lost from giving up some autonomy," Dr. Cohen said in his speech, titled "Promising Change."

Cohen highlighted the AAMC's new institutes, the Institute for Improvement in Medical Education and the Institute for Improving Clinical Care, as examples of the association's strengthened commitment to serve as an agent of change.

Additionally, outgoing AAMC Chair Donald Wilson, M.D., dean and vice president for medical affairs at the University of Maryland School of Medicine, urged AAMC members to meet some of the biggest challenges facing academic medicine - closing the health disparities gap and increasing diversity in the healthcare workforce.

With roughly 16 percent of the U.S. gross domestic product going toward healthcare services, Dr. Wilson said the academic medicine community must find ways to extend better, more comprehensive care to all citizens, regardless of race or ethnicity. Regarding diversity, he said the AAMC could be a leader in putting a more multicultural face on medicine.

"Race is still a powerful determinant of healthcare, and nothing will change without improving diversity," Dr. Wilson said. "We need to make all physicians aware of the cultural sensitivities needed to treat all patients."

N. Lynn Eckhert, M.D., M.P.H., Dr. P.H., director of academic programs for Harvard Medical International, begins her one-year tenure as chair
of the AAMC. Thomas M. Priselac, president and chief executive officer of Cedars-Sinai Health System, was named AAMC chair-elect.

In addition to Dr. Cohen and Dr. Wilson's calls for change in academic medicine, CDC Director Julie Gerberding, M.D., M.P.H., discussed the growing and ever-complicated need to defend the public health. She pointed to rapid global changes and their implications as reasons to safeguard academic medicine's services and resources.

Christine Cassel, M.D., and Clayton Christensen both touched on subjects of great interest to the AAMC membership and the current healthcare community: professionalism among physicians and the current healthcare crisis in the United States. Dr. Cassel, president of the American Board of Internal Medicine, delivered a lecture titled "Professionalism: The Refuge, the Risk and the Reward."

Christensen, the Robert and Jane Czik Professor of Business Administration at Harvard Business School, gave an address titled "The Innovator's Solution to America's Health Care Crisis." He discussed how organiza-tions struggle to adapt with the dem- ands of the marketplace while also trying to stay competitive using innovations in technology.

Moving beyond healthcare issues, Boston Globe columnist Ellen Goodman discussed how journalists' perceptions of private life versus public actions have changed over the decades in her keynote address. In her presentation, Goodman outlined how the national media has shifted gears by treating a public figure's personal activities as indicators of their public actions. Goodman said that in doing so, the media helped reduce political campaigns to discussions of morals and ethics rather than issues.

But the topic that generated the most widespread interest during the meeting was the recent presidential election and its impact on healthcare. Boston Globe columnist Tom Oliphant, former Secretary of Labor Robert Reich and former U.S. Senator Alan Simpson discussed why Americans re-elected President George Bush and what the political landscape could look like in the near future.

Concluding that an increase in support among women voters provided Bush's margin of victory, Oliphant predicted that the outlook for healthcare in the United States is bleak. Healthcare costs will continue to rise, adequate health insurance will slip away from more Americans and promised funding for several national healthcare programs is unlikely to materialize, he said.

"There are definite tears in the safety net that are becoming visible and tangible," Oliphant said. "These conditions are alarming."

Rather than give the current healthcare system more money and resources to provide improved services to patients, the Bush administration could eliminate health- care insurance as an employer's responsibility, giving employees complete control over their healthcare choices, he said.

In a lively and often humorous exchange, Reich and Simpson discussed U.S. Senator John Kerry's presidential campaign and offered two reasons for his failure to win the presidency. In Reich's view, Kerry focused too heavily on policy questions and not enough on his moral vision for the country, and the overall campaign placed too much emphasis on opposition to President Bush.

Although both speakers agreed that Republicans and Democrats across the country share common ground, Reich and Simpson suggested that the face of each party would change over the next four years with new leadership. They agreed that both sides of the aisle have rising stars to keep an eye on. n

-Whitney L.J. Howell, whowell@aamc.org

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