March 14, 1997

Conference spotlights rapidly changing world of health care

Conference spotlights rapidly changing world of health care

reporter_3.14.97_2.jpg (18k)

Meharry Medical College President Dr. John Maupin, VUMC's Dr. Harry Jacobson, and Richard Zaner, Ph.D., discussed the future of academic health centers at the recent conference here on health care issues.

reporter_3.14.97_3.jpg (16k)

U.S. Senator Bill Frist kicked off "The Changing Health Care Environment: Issues for the Future," conference held recently at VUMC.

Rapid decision-making and quick response to evolving market realities are two attributes rarely mentioned when describing large organizations such as academic health centers (AHCs).

That, however, must change if AHCs like Vanderbilt University Medical Center are to survive and thrive in today's volatile health care market, which combines the mounting pressures of managed care and market competition with dwindling federal funding for research and education.

"The traditional three-part mission of research, education and patient care is changing," said Dr. Harry R. Jacobson, professor of Medicine and deputy vice chancellor for Health Affairs. "The future of academic health centers is impacted by challenges to the clinical enterprise, which is being challenged by managed care.

"As profits from the clinical enterprise are challenged, financing for research and education are challenged."

Jacobson, along with Richard M. Zaner, Ph.D., Ann Geddes Stahlman professor of Medical Ethics, and Dr. John E. Maupin Jr., president of Meharry Medical College, discussed the future of AHCs as part of "The Changing Health Care Environment: Issues for the Future," a national conference on health care held at VUMC last week.

Presented by the Vanderbilt University School of Medicine's division of Continuing Medical Education and the American Society of Law, Medicine & Ethics, the conference consisted of discussion sessions dealing with various business, legal, ethical and policy issues surrounding health care.

Among those taking part were representatives from numerous law firms, national health care companies and other AHCs, such as George Washington University Medical Center, Michigan State University and Saint Louis University.

U.S. Sen. William H. Frist, on leave from Vanderbilt, started the conference by hosting a discussion titled "Where Are We and Where Should We Be?" Other sessions covered such topics as legal issues in physician contracting, institutional ethics, liability and ethical issues for managed care providers and a look at TennCare and the needs of the poor.

According to Jacobson, AHCs must reinvent themselves to adapt to a rapidly evolving health care market.

"We must be quick, decisive, manage risk and further develop primary care networks. We must collaborate with other health care providers and demonstrate value to patients and consumers.

"To do all this, we need strong leadership, because strong leadership is the most critical factor in institutional survival."

Meharry's Maupin said that teaching institutions and AHCs push into new market areas while at the same time maintaining a lid on costs.

"There is a need to develop primary care networks to retain and expand market share. We need to go places we've never been before, outside of traditional markets and we must reduce clinical service costs," he said.

The key to becoming a strong integrated health care delivery system is to recognize that there is no single structure that will cover all the bases, all the components ‹ research, education and patient care ‹ must act in concert to achieve institutional goals.

"Clinical enterprise decisions must consider education and research," Jacobson said. "At the same time, the medical schools and research enterprises should extend to the delivery of health care."