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Thoughts on Academic Medicine

Academic Medicine is undergoing great change.

The AAMC and Mayo Clinic report a spike in depression and problems in older physicians, who trained in one era and now live in a different one.

I submit that we focus too much on quantitative and business metrics, and focus too little on the personal measures of purpose, satisfaction and impact. 

In many ways, the purpose and business of medicine are at some odds, with the purpose being prevent failure and the business being rescue from failure.

Lists and rankings are in the front of mind to many organizations, and although we pay attention to these, too – they are not our first focus.

We believe that solving real problems of real people and implementing these solutions in rapid learning cycle- based impact and outcome meets our “why” or purpose - working collaboratively to change the future of our state and for our citizens and for our healthcare delivery teams, tying the purpose and business of medicine together.

There are three parts to solving this conundrum.

The first is our team – talent and culture.

We are mirroring a successful approach taken by Herb Kelleher, CEO of Southwest, where he decided to invest in his employees primarily as opposed to his customers.

He built family and provided a feeling of support, safety and love for his team.

As previously blogged, Abraham Maslow, the famous psychologist came up with his hierarchy of emotional states.

Providing for safety and love are needed to get to the level of self-actualization and to provide real breakthroughs.

We are also following the findings in Dan Pink’s Drive, which gives us the insights that cognitive workers do worse when focused entirely on financial incentives, but do better when enabled to focus on autonomy, mastery and purpose.

Dan Pink's "Drive"

The second is to become an antifragile organization – that is learning by focusing on being more bottoms up instead of all top down.

This happens through empowerment, risk tolerance and collaboration of our team.

We want our folks to dare to do great things, which require they feel safe to fail and learn, in order to create greater impact.

We need to remember that most people and organizations are all part of the cacophony of voices screaming for attention, while only the select few resonate.

Another words, being part of the small amount of signal is critically important.

Thus, the risk of not being part of the signal (risk of omission) is much greater than the risk of failing (risk of commission).

To reach our goals of contributing to changing the future of the state, we need to work collaboratively with others (community programs, healthcare delivery systems, funding agencies/payers and policy/government organizations). 

If we all work to a greater goal set, and play scramble golf together toward a collective goal, we will realize a much better future.

The third is to connect the purpose and business of medicine.

Assuming financial risk for our Medicaid population in West Virginia does this.

We have communicated that the three legs of the stool for our university is prosperity, education and healthcare.

We need to reduce the spending on healthcare, align all providers to benefit by keeping our citizens healthy, but also have the financial ability to employ subspecialty and super-subspecialty care providers to support people in the state.

Our citizens need access to well care and very sophisticated sick care, as well.

By saving state and federal monies, we can invest in prosperity/jobs and education, which contribute to health.