AAMC Reporter: February 2005

A Word from the President: "The Disturbing Realities of Public Perception"

Everyone knows that medical schools and teaching hospitals do the Lord's work, right? Wrong! It may be hard for us on the inside to accept, but in reality the man on the street has a very meager understanding of what we in academic medicine do. What's even more disturbing, many key staffers on Capitol Hill also lack awareness of what actually goes on in our institutions.

We've been reminded yet again of these disturbing realities by the AAMC's recently completed round of opinion research targeted at both the public (i.e., eligible voters) and congressional staffers. Our periodic effort to do this kind of survey work is designed to follow trends over time in the perceptions of these important audiences and to help us craft the right messages to offset the many misperceptions identified.

Here are some of the more arresting findings from this research:

• Barely 40 percent of the public is aware even of the existence of the National Institutes of Health (NIH), let alone what it does
• Only 40 percent of congressional staffers report knowing how or where the NIH spends its appropriated research funds
• Neither voters nor congressional staffers perceive our institutions as the main sites of medical research
• 40 percent of congressional staffers think that private companies are most responsible for medical innovations; only 28 percent think that medical schools and teaching hospitals are most responsible
• While 82 percent of Democratic staffers said they would support a five percent increase in the NIH budget over each of the next five years, only 40 percent of Republican staffers said they would support, and 44 percent said they would oppose such an increase (Recall, if you will, which party controls both houses of Congress!)
• Only 18 percent of Republican staffers support increased funding for teaching hospitals
• A significant percent of the public is either unaware or doesn't believe that teaching hospitals face financial hardship (29%), care for low-income patients (38%), and are largely not-for-profit institutions (65%)

See more details on the survey results in the January 2005 Reporter.

As if the outlook for ominously tight budgets didn't pose enough problems already, these findings underscore how much more work we have to do to educate policymakers about who we are and what we do. Our ability to hold on to the federal (and state) support we now have, let alone to secure additional needed assistance, is heavily dependent on our ability to close this knowledge gap. Given the extent of the gap, everyone in our community has a role to play in this educational effort.

In response to this challenge, the association is launching a strategic communications initiative, called “Fulfilling the Promise”, to build and sustain policymaker awareness of the essential partnership between our community and the NIH. A key element of this effort will be a series of congressional staff briefings that will showcase NIH institute directors and investigators at AAMC-member institutions with whom they collaborate. We also will be sending regular reports to congressional offices highlighting the progress achieved by NIH-supported research at medical schools and teaching hospitals. I invite you to join us in this important educational effort. To learn more about how you can get involved, go to the AAMC's Fulfilling the Promise Web site. (You will need to use your AAMC Login to access this site.)

In addition, a number of AAMC-sponsored groups are already hard at work getting our message across to key audiences. Our Medicare Special Action Committee, chaired again this year by Steve Lipstein, president of BJC HealthCare in St. Louis, is gearing up to combat another planned reduction in the Medicare IME payment to teaching hospitals. This committee is also preparing to fight anticipated cuts in the federal Medicaid budget. The Coalition to Protect America's Health Care, a national coalition of hospitals and other healthcare providers that the AAMC helped found, is busy honing its strategy in support of Medicare and Medicaid; the coalition's primary advocacy tool is well-targeted advertising, which derives its messages from the kind of public opinion research outlined above.

The AAMC-led Ad Hoc Group on Medical Research has a longstanding record of responsible advocacy on behalf of the NIH and is in the process of crafting this year's budget request for that agency. Knowing that an exceptionally difficult budget battle is in the offing, the Ad Hoc Group is redoubling its efforts to educate lawmakers about the necessity of continuing to augment federal investments in medical research. The NIH is also facing the prospects of congressional re-authorization this year; it was last re-authorized in 1993 and the world has changed a lot since then. Given the multiple and complex issues that are certain to be raised during the reauthorization process, the AAMC has formed a working group, co-chaired by Philip Pizzo, M.D., dean of Stanford University Medical School, and Bob Kelch, M.D., executive vice president for medical affairs at the University of Michigan Health System, to help formulate our recommendations to Congress as it deliberates the future of this critically important agency.

Finally, let me mention Project Medical Education (PME), which is yet another vitally important means of increasing policymaker understanding about medical schools and teaching hospitals. With many new faces joining Congress this year, now is the ideal time to host a PME event at your institution. There is no better way to reinforce the importance of what we do than by bringing members of Congress, state officials, and key staffers to your campus so they can have direct contact with students, residents and faculty.

The message from our recent opinion research comes through loud and clear: Unless we act vigorously to educate those whose support we earnestly seek, we risk losing the support we urgently need.

Jordan J. Cohen, M.D.
AAMC President

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