The 2008 Medicare Physician Fee Schedule issued by the Center for Medicare and Medicaid Services (CMS) this week means an increase in payments for ophthalmology of $154 million, or approximately 2 percent over existing payments. However, the increase could be more than offset by a 10.1 percent reduction in payments under the flawed sustainable growth rate (SGR) formula unless Congress intervenes to stop the cuts.

November 7, 2007 – 11:19 am | posted in Medical Students

Darrell G. Kirch, M.D., president and chief executive officer of the AAMC (Association of American Medical Colleges), urged the leadership of the nation’s medical schools and teaching hospitals to change the culture of academic medicine by emphasizing “collaboration, shared accountability, and team performance.”

Dr. Kirch’s remarks, “Culture and the Courage to Change,” were presented at the 2007 AAMC annual meeting in Washington, D.C., before a record 4,000 attendees.

Recognizing that this culture change will require courage, Dr. Kirch also stressed the potential for this shift to create “a much more meaningful and gratifying culture for our faculty, staff, learners, and especially the patients they have committed to serve.”

While medical schools and teaching hospitals have expended considerable effort on growth strategies because of constraints in state and federal support over the past 10 years, a “failure to put at least as much energy into improving our culture as we put into advancing our strategy,” according to Dr. Kirch, “has led to a fundamental imbalance within our institutions.”

“While higher education and health care have held fast to their traditional, individualistic culture,” Dr. Kirch noted that the world has fundamentally changed to a greater emphasis on collaborative, coordinated, and integrative efforts in research, patient care, and medical education.

Acknowledging that this culture change may be difficult, Dr. Kirch noted that the transformation is already underway at many medical schools and teaching hospitals around the country.

Dr. Kirch also urged the academic medicine community not to abandon every element of the current culture as it pursues change, and to fight to “retain its commitment to overall excellence” even as it shifts to more collaborative structures.

“Excellence is excellence,” he said, “regardless of how we get there.”

The Association of American Medical Colleges is a nonprofit association representing all 126 accredited U.S. and 17 accredited Canadian medical schools; nearly 400 major teaching hospitals and health systems, including 68 Department of Veterans Affairs medical centers; and 94 academic and scientific societies. Through these institutions and organizations, the AAMC represents 109,000 faculty members, 67,000 medical students, and 104,000 resident physicians.

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