AUTHOR COMMENTARIES  THE TRANSFORMATION OF ACADEMIC HEALTH CENTERS: MEETING THE CHALLENGES OF HEALTHCARE’S CHANGING LANDSCAPE

AAHC’s book, The Transformation of Academic Health Centers, provides comprehensive and forward-thinking perspectives that are of deep value to those who lead and work at academic health centers, as well as those interested in the future of health professions education, research, and patient care and population health.

These personal reflections by the authors of the chapters in the book reveal insightful underlying currents behind their observations—observations that dip beneath the surface and add meaning and depth to the material covered in the book.

Section I: The Evolution of the Academic Health Center

Chapter 1: The Changing Ivory Tower: Balancing Mission and Business   (Paul B. Rothman, MD)
In this commentary on chapter one of The Transformation of Academic Health Centers, the author discusses how history offers plenty of lessons for academic health centers, but the pressures emerging in academic medicine today are different than they have been in the past. He emphasizes that if institutions like these are to remain leaders in the field, they must embrace new approaches and new ways of thinking. 

Chapter 2: Presidential and Academic Health Center Leadership within the Modern University: Opportunities and Challenges   (Ricardo Azziz, MD, MBA, MPH; Christopher C. Colenda, MD, MPH)
In this commentary on chapter two of The Transformation of Academic Health Centers, the authors reflect on their sizeable experience as academic health center leaders and discuss how university presidents and academic health center leaders can work synergistically to create a unified cultural and corporate identity.

Chapter 3: How Academic Health Centers are Transforming Leadership, Administration, and Management: A Case Study   (Jeffrey R. Balser, MD, PhD)
In this commentary on chapter three of The Transformation of Academic Health Centers, the author emphasizes that it is no longer viable to keep academic department chairs and health system leaders set apart, as they have been in the more traditional models of academic health center governance. In the future, everyone will be engaged in the management of the academic health center enterprise. This is a time of great experimentation.

Chapter 4: The Changing Roles and Expectations of Faculty   (Robert N. Golden, MD)
In this commentary on chapter four of The Transformation of Academic Health Centers, the author underscores that academic medicine has been incredibly powerful and effective over the past century, largely due to its faculty. Thoughtful consideration of the changing roles and expectations for faculty can lay the foundation for success in the continued evolution of academic health centers.

Chapter 5: Universal Lessons for Academic Health Science Centers—Recognizing the Value of Integration   (Catharine Whiteside, MD, PhD, FRCPC)
In this commentary on chapter five of The Transformation of Academic Health Centers, the author notes that it is important for academic leadership to understand the value they bring to the collective, as well as to the partnerships among the various institutions that create the academic health science network. It’s not just about the centers anymore, as they network more broadly among the partners.

Chapter 6: Future Directions   (Victor J. Dzau, MD)
In this commentary on chapter six of The Transformation of Academic Health Centers, the author highlights the advantages that academic health centers hold and that they can leverage tools that no other system can. He argues that academic health centers must become vertically integrated organizations that address population health, the continuum of care, and the fundamental design of healthcare delivery itself.

Section II: Educating the Future Health Workforce

Chapter 7: Disruptive Technologies Affecting Education and Their Implications for Curricular Redesign   (C. Donald Combs, PhD)
In this commentary on chapter seven of The Transformation of Academic Health Centers, the author emphasizes that the pace of technological change is accelerating at a faster rate than many educators and administrators had expected. Noting that the need to evolve is permanent, he argues that habit is an increasingly harmful attitude in an era of rapid technological change.

Chapter 8: Diversity in the Academic Health Center: Progress and Opportunities   (Jay A. Gershen, DDS, PhD; Sonja Haywood, MD; Jeffrey L. Susman, MD)
In this commentary on chapter eight of The Transformation of Academic Health Centers, the authors reflect on the importance of diversity and the need to develop effective pipelines, noting we can’t wait for people to simply seek health professions careers, but must develop robust pipelines to the health professions, beginning in primary education and supported by intrusive advising, mentoring, and role modeling.

Chapter 9: The Growing Integration of Health Professions Education   (Frank B. Cerra, MD)
In this commentary on chapter nine of The Transformation of Academic Health Centers, the author reflects on his experience and the importance of interprofessional education and collaborative practice. He notes that academic health centers should undertake team care both experientially and didactically, while forming new partnerships with the care delivery system and its components.

Chapter 10: Advancing Collaborative Global Education Programs   (Yang Ke, MD)
In this commentary on chapter ten of The Transformation of Academic Health Centers, the author notes that her goal in writing the chapter was to provide the reader with comprehensive and useful information on the existing types of collaborative global education programs and the challenges and barriers that may hinder the successful implementation of such programs, and, more importantly, some strategies for coping with these challenges.

Chapter 11: The Future of Graduate Medical Education: Is There a Path Forward?   (Philip A. Pizzo, MD)
In this commentary on chapter eleven of The Transformation of Academic Health Centers, the author summarizes his perspective on how graduate medical education must and can move forward to adapt to new realities and contribute to the future physician workforce.

Chapter 12: Guiding the Future of Graduate Medical Education through “Enlightened” Accreditation Policy   (Michael F. Collins, MD, FACP)
In this commentary on chapter twelve of The Transformation of Academic Health Centers, the author reflects on the enormous institutional opportunities in the accreditation process and notes that the entire institution should mobilize during an accreditation, and for good reason.

Chapter 13: The Compelling Need for Education Reform: A Futurist’s View of Health Professions Education   (Wiley W. Souba, MD, ScD, MBA)
In this commentary on chapter thirteen of The Transformation of Academic Health Centers, the author discusses how he is struck by the connections and synergies among and between the new dimensions of medical education that need to be embedded into the curriculum and how new themes raise a host of interesting questions.

Section III: The Challenge of Discovery

Chapter 14: The Changing Spectrum of Biomedical and Clinical Research   (Howard J. Federoff, MD, PhD)
In this commentary on chapter fourteen of The Transformation of Academic Health Centers, the author notes that he tried in his chapter to capture the trajectory of the decline in research funding as it relates to the biomedical research enterprise, and discusses the implications of that with regard to what operating models might be effective in this current era.

Chapter 15: Managing, Funding, and Supporting Research   (Craig Johnson, MBA)
In this commentary on chapter fifteen of The Transformation of Academic Health Centers, the author noted that academic health centers are held in the public trust to advance knowledge, train the next generation, and deliver care to patients. Given the challenges brewing just off the horizon, these institutions will all be better off facing them together. A goal of this chapter is to contribute to that conversation. 

Chapter 16: Transformative Changes to Embrace, Manage, and Exploit “Big Data (Arthur S. Levine, MD; Michelle L. Kienholz; Rebecca S. Crowley, MD, MS; Jeremy M. Berg, PhD)
In this commentary on chapter sixteen of The Transformation of Academic Health Centers, the authors reflect on how they were well aware of challenging issues before undertaking this chapter, but writing their thoughts in this form confirmed and underscored that, when it comes to making sense of big data, the vision and the reality remain far apart because of how challenging a problem it is.

Chapter 17: Bridging Science and Practice—A Case Study: The Military Translation of Innovative Responses to Urgent Military Medical Needs Into Widespread Clinical Practice   (Charles L. Rice, MD)
In this commentary on chapter seventeen of The Transformation of Academic Health Centers, the author reflects on how this chapter forced him to think in more depth than he had before about the enormous array of clinical research that is conducted in the Department of Defense. That research covers a broad spectrum of issues, some of which are particular to the military, but much of which are relevant to the civilian world.

Chapter 18: How Research Can and Should Inform Public Policy   (Claire Pomeroy, MD, MBA; Fred Sanfilippo, MD, PhD)
In this commentary on chapter eighteen of The Transformation of Academic Health Centers, the authors note that writing the chapter helped crystallize the opportunities that academic health centers and researchers have to use their work to address important societal questions. By that, they mean that academic health centers should define the questions that society, patients, and healthcare need answered and then work to provide evidence that will help inform policy.

Section IV: Preparing for Health System Change

Chapter 19: Population health and the Patient   (Jay A Perman, MD)
In this commentary on chapter nineteen of The Transformation of Academic Health Centers, the author finds that interwoven in this chapter are two themes that need to come together: the connection between social determinants of health and interprofessional care. First, we are clearly in an age when we need to address population health. Second, if we want to have a healthy population or return people to health, particularly those people with chronic diseases, then we have to think about team-based care

Chapter 20: The Changing Delivery of Patient Care   (Bradford C. Berk, MD, PhD)
In this commentary on chapter twenty of The Transformation of Academic Health Centers, the author reflects on how the ivory tower is no more. The same applies to our traditional “hub and spoke” model. The hospital is no longer the center of our universe. It is really the patient who is at the center.

Chapter 21: Making the Patient Paramount   (James Merlino, MD)
In this commentary on chapter twenty-one of The Transformation of Academic Health Centers, the author reflected on his experience in keeping the patient at the center and how it requires a willingness to lead, an ability to execute, and a desire or passion to constantly think about putting the patient at the center of everything that we do.

Chapter 22: Positioning Academic Health Centers for Quality, Safety, and Patient Empowerment   (Carolyn M. Clancy, MD; Arthur Garson, Jr., MD, MPH)
In this commentary on chapter twenty-two of The Transformation of Academic Health Centers, the authors summarize four key takeaways they wanted to make clear in their chapter in how academic health centers can enhance the patient experience.

Chapter 23: Information Technology and Better Health: Overcoming the Risks   (Randolph W. Hall, PhD)
In this commentary on chapter twenty-three of The Transformation of Academic Health Centers, the author highlights the many risks associated with IT projects, and that CEOs of academic health centers need to pay attention to those risks. There is a methodology for managing those risks and if you implement the methodology, those risks can be greatly diminished.

Chapter 24: Market Consolidation and Alignment   (Larry R. Kaiser, MD, FACS)
In this commentary on chapter twenty-four of The Transformation of Academic Health Centers, the author summarizes the many aspects of a consolidating market and notes that academic health center leaders need to be deeply cognizant of the market in which they exist.

Section V: Conclusion

Chapter 25: Academic Health Center Transformation: Future Shock or Future Success?   (Steven A. Wartman, MD, PhD, MACP)
In this commentary on chapter twenty-five of The Transformation of Academic Health Centers, the chapter author and editor of the book notes that while every academic health center has its unique culture, the challenges and opportunities being faced are quite similar. He summarizes that the central challenges for academic health centers pivot around leadership and alignment.  

TABLE OF CONTENTS

Section I: The Evolution of the Academic Health Center

Section II: Educating the Future Health Workforce

Section III: The Challenge of Discovery

Section IV: Preparing for Health System Change

Section V: Conclusion