This essay by Albany Medical Center President and Chief Executive Officer James J. Barba, originally titled "Health Care in Hands of Academics," appeared in the Albany Times Union on Aug. 27, 2007.
While the American public continues its fascination with celebrity misadventures this summer, there are two other topics that, thankfully, continue to receive substantial news coverage - the war in Iraq and the state of healthcare in America (the latter, in part, thanks to Michael Moore's film "Sicko"). These two issues rightly command our ongoing attention since lives are literally at stake in each.
Unfortunately, there's another topic not on the public's "radar screen" - the need for continued government and public support of academic medical centers. An Association of American Medical Colleges survey a few years ago discovered that fewer than half of Americans had a favorable impression of academic medical centers, with many not able even to define the term.
This is unfortunate because these centers, 125 of them across the country including Albany Medical Center here in the Capital Region, are the institutions where advances in patient care occur; where the next generation of physicians and scientists are trained; and where medical breakthroughs are made through biomedical research. They drive innovations in healthcare and ensure a steady supply of competent physicians and scientists for the future.
Most academic medical centers consist of at least one major teaching hospital working with a medical school. Albany Medical Center is made up of two primary institutions - the Albany Medical Center Hospital and the Albany Medical College.
To succeed, academic medical centers rely on sound business strategies and a combination of private philanthropy, private health insurance and government support in the form of Medicare and Medicaid reimbursements - as well as biomedical research grants from the National Institutes of Health (NIH) and other sources.
These funding sources have not kept pace with inflation, and this trend threatens to weaken these important institutions. Yet, as the AAMC survey indicated, most members of the public do not understand the vital roles such institutions play.
It's a safe bet that most Capital Region residents are not aware that our medical school received close to $18 million in sponsored research grants in 2006. Locally, only the state Wadsworth Center receives more NIH funding annually than does the Albany Medical College.
More than 110 scientists (including faculty and post-doctoral fellows) and more than 80 physician scientists and 40 clinical research coordinators labor in Albany Medical College laboratories to increase our understanding of disease processes and to develop better techniques and treatments for patients. Research ranges from determining the factors leading to a failing heart to the development of a serum to ward off the tularemia bacteria. The latter was the topic of an excellent page one story in the Times Union recently by reporter Cathleen Crowley.
The flat-lining of NIH funding concerns our scientists because it will make it more difficult for them to get grants. The success rates of awards compared with applications has slipped from close to one in three applications in the late 1990s to one in five.
Our faculty also educates and trains more than 500 medical students, several hundred resident physicians and more than 100 graduate students in the health sciences. More than two-thirds of the physicians practicing in the Capital Region either graduated from the Albany Medical College or did their residencies at the Albany Medical Center Hospital. These educational and training programs must remain strong if we are to have appropriate professionals in place for the anticipated upsurge in patient care that will come as the baby boomers continue to age.
If the ills of our healthcare system as portrayed in Moore's film are to be fixed, the reform must start at our academic medical centers. At the Albany Medical College, students are challenged to devise better approaches to care through a course titled "Health Care and Society" and through "standardized patient" encounters, wherein they examine and interview mock patients feigning particular illnesses and conditions.
Our Alden March Bioethics Institute plays an important role is focusing the debate on the myriad of ethical issues associated with our rapidly evolving healthcare system.
The Capital Region is blessed to have an academic medical center at the hub of its healthcare system. None of us should ever take this gem for granted. A citizenry knowledgeable about academic medical centers is critical, because the future of medicine and healthcare - which rests in these institutions' collective hands - is as important an issue as any we face.