Academic Medicine은 환자 중심 의료이다
Academic Medicine Is Patient‐Centered Medicine
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The tripartite mission of ‘academic medicine’ is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on ‘a patient-centered approach,’ which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries’ healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.
Abstract
The tripartite mission of ‘academic medicine’ is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on ‘a patient-centered approach,’ which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries’ healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.
참고문헌 (71)
- Kanter SL, "What is academic medicine?", Acad Med, 83(3), pp.205~206 (2008)
- Olivia Kingston, "Academic medicine", BMJ, 336(7653), pp.s172~s172 (2018), BMJ[DOI]
- "‘Academic medicine’ evangelist, Hee Chul Han, the chairman of the board of directors of KAMC" (2017)[URL]
- 이규식, "보건의료체계의 발전과 성찰", 보건행정학회지, 23(4), pp.303~313 (2013), 한국보건행정학회[DOI]
- Kwon S, "Thirty years of national health insurance in South Korea : lessons for achieving universal health care coverage", Health Policy Plan, 24(1), pp.63~71 (2009)
- Lee EK, "Current issues and policy directions for the national health insurance", Health Welf Policy Forum, (256), pp.51~64 (2018)
- Stein D, "Disruptive innovation in academic medical centers : balancing accountable and academic care", Acad Med, 90(5), pp.594~598 (2015)
- Chung YH, "Comparison of US and UK for health care reform", Health Welf Policy Forum, (102), pp.77~87 (2005)
- Kim CY, "Health coverage system of the united state (1): past and present", Health Insur Forum, 3(4), pp.52~66 (2004)
- "Managed care fact sheets > national managed care penetration:managed care penetration 2017" (2018)[URL]
- Phillips RL Jr, "The Balanced Budget Act of 1997 and the financial health of teaching hospitals", Ann Fam Med, 2(1), pp.71~78 (2004)
- Obama B, "United States health care reform : progress to date and next steps", JAMA, 316(5), pp.525~532 (2016)
- "US hospitals are now required by law to post prices online: good luck finding them" (2019)[URL]
- "Cleveland Clinic 2007 annual report" (2007)[URL]
- Miller JC, "Perspective: follow the money: the implications of medical schools’ funds flow models", Acad Med, 87(12), pp.1746~1751 (2012)
- "Research project grants: average funding in current and constant dollars: NIH data book report ID 155" (2018)[URL]
- Densen P, "Challenges and opportunities facing medical education", Trans Am Clin Climatol Assoc, 122, pp.48~58 (2011)
- "New research shows increasing physician shortages in both primary and specialty care" (2018)[URL]
- "Physician-Scientist Workforce Working Group Report" (2014)[URL]
- Tsugawa Y, "Physician age and outcomes in elderly patients in hospital in the US:observational study", BMJ, 357, pp.j1797~ (2017)
- "NIH report warns of looming shortage of physician-scientists" (2014)[URL]
- Daniels RJ, "A generation at risk: young investigators and the future of the biomedical workforce", Proc Natl Acad Sci U S A, 112(2), pp.313~318 (2015)
- "Medical student education:debt, costs, and load repayment fact card" (2018)[URL]
- Furuya H, "On the brink of extinction: the future of translational physician-scientists in the United States", J Transl Med, 15(1), pp.88~ (2017)
- Schindler BA, "The impact of the changing health care environment on the health and well-being of faculty at four medical schools", Acad Med, 81(1), pp.27~34 (2006)
- Souba WW, "Academic medicine and the search for meaning and purpose", Acad Med, 77(2), pp.139~144 (2002)
- Campbell EG, "Status of clinical research in academic health centers : views from the research leadership", JAMA, 286(7), pp.800~806 (2001)
- Feldman AM, "Pursuing excellence in healthcare: preserving America’s academic medical centers" (2010), CRC Press
- Zinner DE, "Life-science research within US academic medical centers", JAMA, 302(9), pp.969~976 (2009)
- Meador KJ, "Decline of clinical research in academic medical centers", Neurology, 85(13), pp.1171~1176 (2015)
- Druss BG, "Academic medicine: who is it for?: funding gap between clinical and basic science publications is growing", BMJ, 330(7487), pp.360~361 (2005)
- "The future of the academic medical center: strategies to avoid a margin meltdown" (2012)[URL]
- Mann DM, "Academic medical center R&D: a call for creating an operational research infrastructure within the academic medical center", Clin Transl Sci, 8(6), pp.871~872 (2015)
- "Why Cleveland Clinic shares its outcomes data with the world" (2016)[URL]
- "Geisinger makes quality pledge that lasts a lifetime" (2018)[URL]
- "Steal this idea: Geisinger CEO David Feinberg explains how giving back money is his system’s most valuable expense" (2018)[URL]
- Hsu J, "Bending the spending curve by altering care delivery patterns : the role of care management within a pioneer ACO", Health Aff(Millwood), 36(5), pp.876~884 (2017)
- Peikes D, "How changes in Washington University’s Medicare coordinated care demonstration pilot ultimately achieved savings", Health Aff(Millwood), 31(6), pp.1216~1226 (2012)
- Ritchie C, "Implementation of an interdisciplinary, team-based complex care support health care model at an academic medical center: impact on health care utilization and quality of life", PLoS One, 11(2), pp.e0148096~ (2016)
- Blumenthal D, "Academic medical centers and high-need, high-cost patients: a call to action", Acad Med, 93(11), pp.1617~1619 (2018)
- Porter ME, "What is value in health care?", N Engl J Med, 363(26), pp.2477~2481 (2010)
- Porter ME, "The strategy that will fix health care", Harv Bus Rev, 91(10), pp.50~70 (2013)
- Roberts P, "Total teamwork: the Mayo Clinic", Radiol Manage, 21(4), pp.29~30 (1999)[DOI]
- "Advancing the academic health system for the future: a report from the AAMC Advisory Panel on Health Care" (2014)[URL]
- "Newsroom: resources for journalists and media outlets:facts and figures: Cleveland Clinic by the numbers" (2019)[URL]
- "Reducing time-to-treatment for newly diagnosed cancer patients" (2019)[URL]
- "A look at our books: fiscal year 2015 capital budget and annual operating plan" (2016)[URL]
- Ries A, "Retention of junior faculty in academic medicine at the University of California, San Diego", Acad Med, 84(1), pp.37~41 (2009)
- Ries A, "Measuring faculty retention and success in academic medicine", Acad Med, 87(8), pp.1046~1051 (2012)
- Choi AM, "Developing a culture of mentorship to strengthen academic medical centers", Acad Med, 94(5), pp.630~633 (2019)
- "Governance, appointment, promotion handbook" (2018)[URL]
- "Professional development guide for the faculty of The Johns Hopkins University School of Medicine" (2016)[URL]
- Straus SE, "Career choice in academic medicine: systematic review", J Gen Intern Med, 21(12), pp.1222~1229 (2006)
- "Medical doctorate thesis" (2019)[URL]
- Cosgrove T, "The Cleveland Clinic way: lessons in excellence from one of the world’s leading health care organizations" (2014), McGraw-Hill Education
- Berry LL, "The enduring culture of Mayo Clinic", Mayo Clin Proc, 89(2), pp.144~147 (2014)
- Scott A, "Employee-free hospitals", Brunswick Rev, 13, pp.46~48 (2017)
- "“The Mayo effect”: ten things you may not know about Mayo Clinic" (2011)[URL]
- Hiebert PG, "Perspectives on the world Christian movement", pp.373~383 (1999), William Carey Library
- Tilburt J, "Viewpoint: the importance of worldviews for medical education", Acad Med, 82(8), pp.819~822 (2007)
- Schein EH, "Organizational culture and leadership" (1985), Jossey-Bass Publishers
- Fullan M, "The new meaning of educational change" (2016), Teachers College Press
- Viggiano TR, "Putting the needs of the patient first: Mayo Clinic’s core value, institutional culture, and professionalism covenant", Acad Med, 82(11), pp.1089~1093 (2007)
- Ferlie E, "The nonspread of innovations : the mediating role of professionals", Acad Manag J, 48(1), pp.117~134 (2005)
- Dzau VJ, "Fostering innovation in medicine and health care: what must academic health centers do?", Acad Med, 88(10), pp.1424~1429 (2013)
- "History" (2019)[URL]
- Chung BK, "Development of basic medical sciences as the platform research and task to be solved", Sci Tech Policy, 23(3), pp.123~135 (2013)
- "Re-ignited debate about telemedicine" (2018)[URL]
- "Medical professors who are about to retire are looking for places to go to hospitals, government agencies, and so forth" (2018)[URL]
- 정수민, "전공의 교육의 현주소 및 나아갈 방향", 대한의사협회지, 62(2), pp.72~77 (2019), 대한의사협회[DOI]
- "A way to support resident education and improvement of training environment by the governmental finance" (2017)[URL]
