Transcript Academic Medicine in the 21 Century (D07-51)

Academic
Medicine in
st
the 21
Century
Richard I. Levin, MD
April 16, 2008
• Maclean’s #1
• Science Essentials #1
• Times of London
12
21
Lister Antisepsis
1865
Venter
& Collins
Osler Graduates
Roddick Asepsis
Marco Marra Long
JohnEther 1872 Human Genome
1877
2001
McPherson 1842
Hippocrates
460 BC
460 BC
Ken Dewar
Harvey
Circulation
1628
Flexner Report
Fleming Penicillin
1910
1928
Penfield Montreal Procedure
1930s
Avery DNA
1944
Hoffman Aspirin
1893
2008 AD
MRI
1980
WHO Smallpox
1977
Watson & Crick
Double Helix Sabiston CABG
1953
1962
Oldendorf &
Hounsfield
CAT Scan
1972
Challenges to Academic Medicine
• Education
• Research
• Care
“The way we … provide instruction
is essentially the same as it was when
our Founding Fathers went to
school...we still educate our students
based on an agricultural timetable,
in an industrial setting, yet tell
students they live in a digital age.”
Paige, 2002
Expansion of
Medical
Knowledge
• 80% of scientists who
ever lived, live now
• 2000 pages of text
added every minute
• 1 days output =
5 yrs reading
• Knowledge doubles
every 7 years
Challenges to Medical Education at the
Dawn of the 21st Century
• Inadequate Resources
• Expansion of Medical Knowledge
• Time in the human classroom of
the hospital has vanished
TEACHING
HOSPITAL
FACULTY
STUDENTS
RESIDENTS
PATIENTS
DIAGNOSTICS, TREATMENTS, RECOVERY
1900 - 1990
TEACHING
HOSPITAL
OFFICES
CONSULTATIONS
DIAGNOSTIC
CENTERS
FACULTY
STUDENTS
RESIDENTS
PATIENTS
AMBULATORY
SURGERY
2008
Simulation
Challenges to Academic Medicine
• Education
• Research
• Care
Uncovering the
Biological Basis of Disease
Translating Research into
Better Health and Care
Era of Great Risk
New Epidemic of Obesity and Diabetes
Costs per Capita in OECD
Countries
Canadian health care costs
have TRIPLED since 1975
National Health Expenditure Trends, 1975–2007 CIHI
Graph 6
Public Health Spending Projections, 2007-08 to 2017-18
(in millions of dollars)
Growth of health spending based on current trends (5.8%)
Increase in health spending based on current rate of economic growth (3.9%) 42,0
2008 Task Force Report on the Financing of the Health System
Castonguay, Venne & Marcotte
Current System
RUIS
MUHC
JGH
St. Mary’s
Douglas
Teaching Affiliates
McGill Academic Health Network
• Coordinate education, research and care
• Recognize special areas of excellence
• Capture, elevate and publicize its power
McGill Academic Health Network
RUIS