May 29, 2013
Dear School of Medicine Community:
This month and next, I meet with the faculty in each of our 27 departments. I see our faculty every day through the regular course of School of Medicine activities and for a variety of reasons, but these meetings have a specific goal. They give us all a chance to step back, look at the big picture together, share OHSU plans and goals, and – most importantly, from my perspective – they give me a chance to listen and answer questions.
Several themes are emerging related to the day-to-day reality – and uncertainty – of this period of rapid change now underway at OHSU and, more broadly, in academic medicine as a whole.
The scope of change and the drivers are unprecedented – reform, curriculum transformation, constraints in traditional sources of research funding, an accelerating influence of information technology on all our missions, among others – at precisely the same time we are entering what many call a potential golden age of biomedicine.
During the meetings, research faculty members shared their grave concerns about the consequences of declining funding from the National Institutes of Health and other traditional sources. We discussed how OHSU aggressively and consistently advocates at the federal level for sustainable research funding, but there are limits to what we can do right now to influence this very short-sighted national approach. We can respond carefully and strategically as an institution, and during the meetings this month, we discussed how we are doing that, including our collective goal of moving quickly to reorganize our use of space, administration resources and other costs in ways that redirect funds directly to research programs and "bridge" funding. We also discussed our near-term plan to invest in initiatives that better position faculty to attract funding from new or novel sources, such as partnerships with industry, academic entities, philanthropic groups and, within OHSU, between departments and investigators.
The role of emerging and evolving technology across all our missions was a topic for several departments. The potential to transform our missions is immense and a good example of that is illustrated by our recently announced partnership with Intel. Similarly, as educational content increasingly moves into an online environment, higher education is poised to undergo a fundamental reshaping across the country and world. Senior Associate Dean George Mejicano provided a glimpse into this future in his 125th anniversary lecture entitled Adaptation and evolution in education: Surviving the impact of the comet headed our way.
Our M.D. Curriculum Transformation initiative was among the liveliest topics at all the meetings, so far. To recap, the goal of the initiative is to ensure we prepare students to thrive in the health care landscape of the future. Several faculty members raised the point that because so many elements are in a process of transition and experimentation no one knows exactly what the future health care landscape will look like. Consequently, different faculty members have different ideas, some sharply so, about how to educate the physician of the future. We discussed how the transformation initiative is designed to bring these different perspectives together, along with those of other members in our community, to achieve meaningful educational innovation.
A topic clearly on the collective minds of our faculty is health care reform itself. Many changes are on the horizon, including reimbursements. In Oregon, a change in the payment paradigm has already begun with the advent of Coordinated Care Organizations and their associated "global budgets." Many initiatives are underway at OHSU, such as community outreach workers helping to reduce visits to the emergency department, and are providing leadership in this new context. In our faculty meetings, we talked specifically about the OPEx initiative, or OHSU Performance Excellence. Grounded in "lean manufacturing" techniques initially developed by Toyota, our goal is to radically – and continuously – improve our workflow, starting in the clinical mission. Performance improvement allows us to ensure we are always directing the maximum funds to our missions and our continued excellence.
These meetings have made clear that the ongoing change leads to a sense of anxiety about the future. Now more than ever it is vital that School of Medicine leaders remain connected to frontline perspectives with open lines of communication. Please don't hesitate to contact me with your concerns, your observations or, especially, your innovative ideas for novel opportunities to meet our missions in this new health care landscape.
More than anyone else, we know the power of diverse perspectives, of conversations and continually striving to improve and innovate. I know these new ideas and growing energy will propel us forward. A key point I sought to share in these meetings, and repeat now more broadly, is the tremendous sense of optimism I have about our future.
The enormous changes taking place open up extraordinary, in some cases, historic windows of opportunity. We must be ready to seize them – at every level, from the individual to the institutional – and help influence the course of human health, across all our missions, for decades to come.
I've focused on the faculty in this message, due mostly to the slate of recent meetings, but the ability to respond to change proactively and effectively is a trait that extends across the entire School of Medicine community. I can think of no other group more uniquely qualified to create the future of health and health care.
Thank you for everything you do for OHSU, Oregon and beyond.
Mark Richardson, MD, MBA
Dean, OHSU School of Medicine
President, Faculty Practice Plan