Academic Mission of the New Hospital: More Than Just the Bottom Line

Abstract

The academic mission (education, research, publication, and patient care) in today’s era of corporate domination is in danger. The problems stem from several issues: (1) cost-effectiveness has become the prime goal for many institutions, reducing clinical spending; (2) hospitals, and especially university hospitals, are costly, mainly because they are high-technology and multidisciplinary enterprises, and reimbursement has declined.

With respect to their teaching mission, the financial constraints and obligations discourage hospitalists from traditional academic pursuits. Moreover, recent reductions in resident training hours and an increasing demand to provide safe and 24-h coverage have altered the traditional role of teachers. Last, working hour restrictions have widened the knowledge gap separating what should be known and what is known and so have intensified the teaching burden on academics.

Teaching and good teachers are costly, and without adequate funding and dedicated faculty time, in or outside the operating room, the quality of the formation of future academics is imperiled.

Lengthy operations and high-tech techniques not only cost more money but take time away from other academic activities. Teaching in the operating room takes more time and costs more. Most countries and faculties are poorly organized with regard to teaching, research, and publishing activities. Solutions have to be found but most likely require a new mind-set for both the academic physicians and the administration. We owe this to our profession and to our patients.