03/28/12 Portland, OR
Dear School of Medicine Community:
I recently attended the annual Council of Deans Spring Meeting hosted by the Association of American Medical Colleges. The meeting brings together medical school deans from around the country – we learn from each other and from invited speakers, we discuss current issues relevant to academic medicine, and we find common ground for long-term advocacy in areas that affect our missions.
The meeting was well attended. This year, not surprisingly, health care reform and evolving systems of care were key areas of focus. The conversations (and predictions) were plentiful, and shaped by the opening deliberations of the U.S. Supreme Court on the Affordable Care Act. While there was a great deal of diversity of thought on these topics, one area of general agreement among the Council of Deans is that reform – no matter the outcome at the Supreme Court – will take place. The pace and the framework will evolve, and the process will be incremental over many years, if not decades, but the pressing need to bring down costs means the future will look different.
While necessary, this evolution will not be easy. The shift away from the exclusivity of the prevailing "fee-for-service" delivery model will be a challenge for people in all facets of the nation's health care system, including those of us in academic medicine. Most in the group concluded that the assimilation rate for any new funding model could be tied to the degree of subsidies available for a transition period.
Despite wariness about the specifics of this transition, in all of my conversations and my observations during this meeting, it was clear there is a genuine commitment to health care reform. Across all medical schools, there is strong momentum and a clear desire to emphasize prevention and population health, and to find ways to integrate the social determinants of health, such as education, environmental health, nutrition and more, into how we care for patients and communities.
The role of efficiency in accelerating reform was topical. There is general agreement that our collective success in lowering health care costs depends on delivering more efficient care. However, those of us from states known for our health care efficiency, such as Oregon, provided an expanded view on this topic – reinforcing the conclusion that efficiency alone will not result in the health care system we all want. Rather, our success depends equally on emerging care delivery models that focus on prevention and health, along with payment structures that reward outcomes.
Another common thread among several of the sessions was excitement around transforming medical school education curriculum in ways that reflect a future in which we are successful at reform, and in ways that support enduring leadership on these topics for decades to come. This is an area in which OHSU has an opportunity to be a national leader.
As the sessions wound down, I was left with an overall impression similar to what I concluded the past few years at this same meeting. Academic medicine is moving into an era of significant change. It's both exciting and, for some, nerve-wracking. After listening to the current experiences and initiatives underway at other medical schools, I can say with a great deal of confidence that OHSU is preparing effectively for our nation's health care transformation. In fact, we will likely be leading the way in some important areas.
This readiness to embrace change and shape the future is linked directly to your commitment and dedication to ensuring the OHSU School of Medicine is, and remains, excellent across all of our missions.
Thank you for everything you do.
Mark Richardson, MD, MBA
Dean, OHSU School of Medicine
President, Faculty Practice Plan