If we keep doing what we’re doing we’ll keep getting what we’re getting: A need to rethink “academic” medicine

Abstract

Purpose: For generations there have been warnings of the need to reform medical education at all levels. Today the voices pushing reform are louder, the need is greater, and there is an urgency not seen before. Approaches that have worked in the past to train physicians are no longer as relevant today as demographics, disease patterns, human resources, practice behaviors, technology, and attention to costs demand new collaborative approaches to clinical practice. To prepare for this practice tomorrow’s doctors will need a different type of educational model, a different type of learning, in different environments, often taught by different faculty. This paper provides one innovative approach to redefine “academic medicine”.

Methods: After reviewing current trends in medical education, this paper describes one approach being taken by a large nonprofit American health care system to move medical education and discovery (research) out of traditional academic universities and placing it within a health care delivery system.

Conclusions: The creation of a learning laboratory in a high functioning health care delivery system allows for leveraging the successes in quality health care delivery to transform medical education with a focus on prevention, improving health care quality, reducing disparities in health, and promoting practical evidence-based clinical and outcomes focused research.

Acknowledgements

The authors wish to thank the many school of medicine team members, patients, providers, and community members who sought to make this new medical school possible.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Academic medicine: Ideally, a social definition of academic medicine would include the ability of a health care system to think, plan, study, research, evaluate, discover, innovate, teach, and learn all with the goal of improving the health of the public. In the US, the Joint Commission International is more pragmatic as it defines an academic medical center as “one that is administratively integrated with a medical school, is the principal site for the education of medical students, and is engaged in clinical research” (JCI 2017).

Additional information

Notes on contributors

Michael Wilkes

Michael Wilkes, MD, Ph.D., is a Professor of Medicine and Global Health and Senior Consultant in Medical Education at the University of California. He has worked to establish new, and revitalize existing, medical and health science schools around the globe.

Christine Cassel

Christine Cassel, MD, is a Professor of Medicine and the Planning Dean for the new Kaiser Permanente School of Medicine. She is a leading expert in geriatric medicine, medical ethics and quality of care. She was President and CEO of the National Quality Forum, and served as President and CEO of the American Board of Internal Medicine.

Marc Klau

Marc Klau, MD, MBA, is an Assistant Professor and the Vice Dean of Education and Clinical Integration for the new Kaiser Permanente School of Medicine. He is Assistant Regional Medical Director of Learning, Education and Leadership, Director of Kaiser Permanente Residencies, and Regional Chief of Head and Neck Surgery.