AAMC Board Chair Kirk A. Calhoun, MD, and AAMC President and CEO David J. Skorton, MD, discuss challenges facing academic medicine during the leadership plenary Nov. 13 at Learn Serve Lead 2022.

AAMC Leaders: Unprecedented times call for concerted action to improve health for all

AAMC President and CEO, David J. Skorton, MD, and AAMC Chairman of the Board, Kirk A. Calhoun, MD, challenged school physicians and scientists of Medicine and American Teaching Hospitals on November 13 to work collectively to improve the health and mental well-being of their colleagues. and communities.

Nearly three years after the COVID-19 pandemic caused massive upheaval in the country’s healthcare system – in response to which “learners, faculty, staff and leaders rose to the occasion magnificently” – challenges subsist. “We still find ourselves in a situation of fragmented communities, often bitterly divided public opinion and serious difficulties in getting along and listening to one another,” Skorton told more than 4,200 healthcare professionals. at the Leadership Plenary of Learn Serve Lead 2022: The AAMC Annual Meeting. .

Deep inequalities, deterioration in learner well-being, threats to the sanctity of the doctor-patient relationship, and the inability of those with opposing viewpoints to find common ground were among the challenges identified by Skorton as those who “keep him up at night”. .” Calhoun also identified similar “headwinds” to fulfilling the multiple missions of academic medicine.

“Academic medicine sits at the crossroads of higher education and health care delivery. Both exist in very treacherous waters of rapidly changing expectations, misinformation, partisan debates and economic pressures,” said Calhoun, president of the University of Texas at Tyler and chairman of the UT board of trustees. Health East Texas. “As we engage in informed and sincere evidence-based dialogue, I implore you to never forget the immediate unmet needs of our patients and their families, our students, faculty and community.”

Calhoun urges renewed attention to increasing diversity in medicine

Calhoun began his talk with a personal story of growing up “a poor, asthmatic black kid bedridden in my mother’s living room.” Indeed, young Calhoun was too ill to go to school and relied on the nuns from the parish school in his community to come to the house to give him lessons.

Everything changed when her mother was able to get her an appointment with an allergist at a University Medical Center in Chicago. The doctor, who was black, examined him and then said, “I know what it is and I know how to fix it.” Those words, spoken by someone who looked like him, completely changed the course of Calhoun’s life, sparking in him the ambition and drive to become a doctor.

Unfortunately, there are still too few doctors of color, despite years of efforts by the AAMC and other organizations, Calhoun noted.

Calhoun told the story of efforts to increase diversity in medical classrooms, including a campaign in the early 1990s known as the “3000 by 2000” project. By the time the project ended in 2000, it was 700 students short of its target. “We have so much more that we need to do,” Calhoun said. “It’s important that we don’t let today’s headwinds deter us.”

Calhoun pointed out that the AAMC’s strategic plan identifies some of the other issues where the headwinds are strong and require member attention. These include efforts to improve opportunities, medical education and research, and access to care, but said that by working together, academic medicine can achieve measurable success for patients and learners. .

“The achievements of academic medicine are immense, and despite the headwinds, our future will be even more remarkable,” he said. “The future of academic medicine is in good hands. He stays in your hands.”

Skorton highlights four concerns that “keep me up at night”

While praising academic medicine’s extraordinary response to the COVID-19 pandemic, Skorton also identified four issues that still plague the nation’s healthcare system, but which academic medicine has the power to address or at least improve. .

The first is the need to improve diversity, equity, inclusion and anti-racism. “The health inequities that have long plagued our healthcare system are partly rooted in prejudice, discrimination and systemic racism,” he told the audience. “And it is our responsibility in medicine to address these issues whenever we have the opportunity. Not just because we have to do it professionally, but because we have to do it as human beings.

In academic medicine, a successful journey to justice means diversifying medical school classes, faculty and staff, and optimizing the culture and climate of academic medical institutions so that each individual has the opportunity to excel, Skorton said. .

The second concern is a deterioration in student well-being, due to financial, but also social and academic pressures. “Depression and therefore suicide risk are more common among medical students than their age-matched peers, and this trend has worsened in recent years,” Skorton said.

He called on leaders in academic medicine to identify and address issues that contribute to student stress, as well as improve access to behavioral health care for all who need it.

The third concern that worries Skorton is the increase in threats to the doctor-patient relationship. This was manifested more recently in the Supreme Court’s overturning of Roe vs. Wadewhich has compromised access to reproductive health care for millions of people.

“I’m not here right now to discuss the merits of abortion access,” Skorton said. “I am here to argue that laws or court opinions that interfere with the doctor-patient relationship, especially if they go so far as to intimidate the clinician in exercising good clinical judgment, are unacceptable. We must stand firm. We have to protect this relationship.

Finally, Skorton emphasized the value of freedom of expression and the need to listen to differing viewpoints. “Let’s challenge ourselves, through ideologies, to be humble, to be kind, to be empathetic and respectful, to listen actively and to be truly open to other opinions, even if they are different from our own .

At the same time, he urged the public to speak out against “intentional and inflammatory misinformation” and to condemn “hate speech, racist speech or speech that incites violence, including violence against health professionals “.

“As with all other issues that keep me awake at night, the issue of free speech requires our collective action now,” he added. “The health and mental well-being of our communities and our colleagues are at stake. Through meaningful, open and honest dialogue, partnership and collective action, we can and will tackle these issues in the service of the greatest great public good.

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