Academic medicine must deal with the clash of business and professional values.
Abstract
Academic medicine faces unprecedented challenges,
especially the impact of the changing and more business-oriented health
care system on medical education. There is an inherent clash of values
between business and medicine: among key business values are profit and
competition, while among the traditional values of the medical
profession are service, advocacy, and altruism. Business interests have
already gained a central place in medicine, so the challenge has become
how to utilize the positive elements of the entrepreneurial spirit to
enhance professional values and advance academic medicine's central
enterprise. The author maintains that to achieve that synthesis, the
leaders of academic medicine must continue to engage in a dialogue with
the broader academic community, the government, the public, and the
health care industry. The dialogue must emphasize
(1) managing change rather than resisting it (such as focusing on the positive aspects of change, keeping sight of the fundamental professional values of medicine and medical education, and maintaining cool, rational judgment in the face of challenges);
(2) making academic medicine's case with many constituencies, such as the health care industry, government, and the public; and
(3) fostering professionalism by increasing medical schools' emphasis on this task, by ensuring that schools keep an appropriate balance between the science and the art of medicine, and by having faculty model appropriate professional values for their students. The author concludes that while change inevitably brings challenge and a sense of loss, it also brings the opportunity to help reshape medical education to meet the needs of society.
(1) managing change rather than resisting it (such as focusing on the positive aspects of change, keeping sight of the fundamental professional values of medicine and medical education, and maintaining cool, rational judgment in the face of challenges);
(2) making academic medicine's case with many constituencies, such as the health care industry, government, and the public; and
(3) fostering professionalism by increasing medical schools' emphasis on this task, by ensuring that schools keep an appropriate balance between the science and the art of medicine, and by having faculty model appropriate professional values for their students. The author concludes that while change inevitably brings challenge and a sense of loss, it also brings the opportunity to help reshape medical education to meet the needs of society.
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