AAMC Reporter: December 2006

AAMC Annual Meeting Highlights Social, Political Change

AAMC President Darrell G. Kirch, M.D., delivers his first presidential address at the AAMC's annual meeting in Seattle

More than 3,400 physicians, medical students, residents, faculty, researchers, and staff representing the entire professional range of academic medicine attended the AAMC's 117th annual meeting in Seattle, held Oct. 27–Nov. 1.

The theme for this year's meeting, "Pursuing Excellence, Creating Value," explored how medical schools and teaching hospitals provide value to society under the highest standards of quality—and how that value can be maximized now and in the future.

In his inaugural annual meeting address, "In Search of the Public Good,"AAMC President Darrell G. Kirch, M.D., said the nation's social values demand that individuals and institutions come together to restore America's commitment to the principle of the "public good."

Expressing concern about rising medical student tuition and debt, a National Institutes of Health budget losing ground with inflation, and rising uninsured population, Kirch called on medical schools and teaching hospitals "to take the risk and leap together into a new national discussion, not a partisan debate," about how the nation can best support education, scientific discovery, and health care for all Americans.

Kirch, along with several other meeting speakers, said national priorities and policies are negatively affected by political polarization, rising education and health care costs, distended federal deficits, and pork-barrel politics. While acknowledging it would be painful, Kirch said medical schools and teaching hospitals are well equipped to take action and lead a national re-commitment to the public good.

"We sit at the intersection of three of the most vital public goods—higher education, scientific discovery, and health care," Kirch said. "I would argue that no one is more uniquely positioned than [academic medicine] to energize this long-overdue national restatement of our priorities."

In his remarks as outgoing AAMC Chair, Thomas M. Priselac, M.P.H., president and chief executive officer of Cedars-Sinai Health System, said academic medical centers were responsible for maintaining—or rebuilding —public trust amid political and societal change. "I believe the leadership imperative for us collectively and individually is to embrace the increasing call for accountability in all elements of our mission so that we can perpetuate the trust vested in us by society," Priselac said.

According to Priselac, medical schools and teaching hospitals should become more involved in the debates over health care costs, conflicts of interest between industry and research interests, and the issues of whether teaching hospitals still deserve their tax-exempt status. "I believe there is substantially more change, particularly around accountability and public scrutiny, yet to come for medicine generally and academic medicine in particular," Priselac said.

A mandate to effect change also came from a speaker not traditionally affiliated with the medical community. Renowned business author Jim Collins, the meeting's keynote speaker, said that in order for "social-sector" organizations like medical schools and teaching hospitals to thrive in an environment of high expectations and dwindling resources, they must stay true to their core values.

"The answer for non-profit organizations is not to become more like a business," Collins said. "In the social sector, money is not a definition of success but a means of success, and we must not forget that. Rather, health outcomes and discovering new treatments are your outputs."

Collins said not-for-profit organizations—particularly in trying times—should "confront the brutal facts" of their situation head-on, stay consistent to the central aspects of one's mission while "stimulating progress in cultural and operating practices," and rely heavily on facts and data to support positions.

Noting that "it's all about getting the right people on the bus," Collins said academic medical centers should focus on developing excellence in their professional ranks, and suggested that the ability to provide medical education—and in turn, draw from the largest possible population base in which to find and educate the best possible doctors—was a "core" that should not be marginalized.

"As a nation, we must have great education, great symphony orchestras, great universities, great academic medical centers, and great access to opportunity,"Collins said. "…Medical education must be available to the best people.We must prevent it from being available only to the best of the wealthy."

During the meeting's "Political Spotlight" presentation, New York Times columnist David Brooks predicted an end to fierce partisanship and the rise of a more independent-minded voting public.

"We are entering an era with no conservative dominance and no liberal dominance, but simply no dominance," Brooks said. "We had a period of intense polarization, but that does not represent this country… I am optimistic about how politics are about to change."

Brooks added, however, that he believes health care issues may not immediately be a top priority for Congress regardless of the party in control.

Other highlights of the meeting included presentations by by Elizabeth G. Nabel, M.D., director of the National Heart, Lung, and Blood Institute, who spoke about the promise of personalized, preventive medicine; and William M. Sullivan, Ph.D., of The Carnegie Foundation for the Advancement of Teaching, who suggested new tactics and goals in physician education during the inaugural Jordan J. Cohen Leadership in Health Care Lecture. John E. Wennberg, M.D., M.P.H., director of Dartmouth Medical School's Center for Evaluative Clinical Sciences, gave the John A.D. Cooper Lecture on the challenge of variation in clinical practice.

Meeting attendees formally elected Richard D. Krugman, M.D., dean of the University of Colorado School of Medicine, officially succeeded Priselac as AAMC chair. Robert J. Desnick, M.D., Ph.D., professor and chair of the department of human genetics at Mount Sinai School of Medicine, was named chair-elect. Ten individuals and institutions were honored at the annual AAMC Awards Dinner.

—By Scott Harris

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