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4 - Pursuing organizational and cultural change

Published online by Cambridge University Press:  12 November 2009

Michael A. Geheb
Affiliation:
Professor of Medicine and Vice President Institutional Advancement at Oregon Health & Science University
Mark L. Penkhus
Affiliation:
Senior Vice President and Chief Development Officer Sheridan Healthcorp
Peter O. Kohler
Affiliation:
President Oregon Health & Science University
Arthur Garson
Affiliation:
Vice President and Dean of the School of Medicine University of Virginia
Jonathan F. Saxton
Affiliation:
Health Policy Analyst Emory University
Michael M. E. Johns
Affiliation:
Executive Vice President Health Affairs at Emory University; Chief Executive Officer Robert W. Woodruff Health Sciences Center
George F. Sheldon
Affiliation:
Professor of Surgery and Social Medicine and former Chair of Surgery University of North Carolina
Don Detmer
Affiliation:
University of Virginia
Elaine Steen
Affiliation:
University of Virginia
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Summary

Introduction

The academic physician, academic medicine, and the health professions in general are in the midst of an extended period of organizational and professional turbulence. Beginning with the explosive growth of managed care in the 1980s, the relatively closed, professionally self-regulated health services sector has been pushed into a more classically competitive marketplace. The 1990s brought additional impetus for change with shifting public policy, changing demographics, increasing consumerism, and the growing influence of information technologies. Further, the turn of the century brought renewed public concern with deficiencies and inconsistencies in the quality of health care services.

The health care sector is clearly laboring under the strains of this changing and demanding environment. The new marketplace is squeezing the financial resources and compensation available to health professionals and organizations. Societal needs, expectations, and aspirations for the health care system have changed and are growing. Academic health centers (AHCs), in particular, continue to face great challenges in adapting their multiple service and academic missions to changing societal, financial, and service requirements.

Academic health centers have adopted measures to improve service, cut costs, and increase productivity. They are learning how to do more with less. They have also worked to develop new capabilities and revenue streams in an attempt to shore-up strained academic and clinical resources. These efforts increase the service and performance expectations for faculty and staff who find it increasingly difficult to pursue research and teaching goals.

Type
Chapter
Information
The Academic Health Center
Leadership and Performance
, pp. 119 - 187
Publisher: Cambridge University Press
Print publication year: 2005

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References

American Board of Internal Medicine (2001). Project Professionalism. Philadelphia, PA: American Board of Internal Medicine Publications. Online at www.abim.org
Angstadt, C. N., Nieman, L. Z. and Morahan, P. S. (1998). Strategies to expand the definition of scholarship for the health professions. Journal of Allied Health, 27(3), 157–61Google ScholarPubMed
Aschenbrener, C. A. (1998). Leadership, culture, and change: critical elements for transformation. In Mission Management: a New Synthesis, Volume 2, ed. E. R. Rubin. Washington, DC: Association of Academic Health Centers
Balas, E. A. (2001). Information systems can prevent errors and improve quality. Journal of the American Medical Informatics Association, 8(4), 398–9CrossRefGoogle ScholarPubMed
Blake, D. A. (1996). Whither academic values during the transition from academic medical centers to integrated health delivery systems?Academic Medicine, 71(8), 818–19CrossRefGoogle ScholarPubMed
Bloom, S. W. (1998). Structure and ideology in medical education: an analysis of resistance to change. Journal of Health and Social Behavior, 29, 294CrossRefGoogle Scholar
Blue Ridge Academic Health Group (1998). Academic Health Centers: Getting Down to Business. Washington, DC: Cap Gemini Ernst & Young US, LLC
Blue Ridge Academic Health Group (2003). Reforming Medical Education: Urgent Priority for the Academic Health Center in the New Century. Atlanta, GA: Emory University
Blumenthal, D. (1997). The future of quality measurement and management in a transforming health care system. Journal of the American Medical Association, 278(19), 1622–5CrossRefGoogle Scholar
Blumenthal, D., Causing, N., Campbell, E. G. and Weissman, J. S. (2001). The relationship of market forces to the satisfaction of faculty at academic health centers. American Journal of Medicine, 111(4), 333–40CrossRefGoogle ScholarPubMed
Boyer, L. L. (1990). Scholarship Reconsidered: Priorities of the Professoriate. Princeton, NJ: Carnegie Foundation for the Advancement of Teaching
Bulger, R. J., Osterweis, M. and Rubin, E. eds. (1999). Mission Management: a New Synthesis. Washington, DC: Association of Academic Health Centers
Commonwealth Fund Task Force on Academic Health Centers (2000). Managing Academic Health Centers: Meeting the Challenges of the New Health Care World. New York: The Commonwealth Fund. Online at www.cmwf.org
Drucker, P. F. (1996). The Executive in Action. New York: Harper Business Press
Drucker, P. F. (1999). Management Challenges for the 21st Century. New York: Harper Business Press
Durkheim, E. (1964). The Division of Labor in Society. New York: The Free Press
Durkheim, E. (1966). Suicide: a Study in Sociology. New York: The Free Press
Eisenberg, L. (1999). Whatever happened to the faculty on the way to the Agora?Archives of Internal Medicine, 159(19), 2251–6CrossRefGoogle ScholarPubMed
Franzini, L., Low, D. and Proll, M. A. (1997). Using a cost-construction model to assess the cost of educating undergraduate medical students at the University of Texas-Houston Medical School. Academic Medicine, 72(3), 228–37CrossRefGoogle ScholarPubMed
Garson, A. (1999). Performance measures and our “art.”Journal of the American College of Cardiology, 34, 607–9Google Scholar
Goodwin, M. C., Gleason, W. M. and Kontos, H. A. (1997). A pilot study of the cost of educating undergraduate medical students at Virginia Commonwealth University. Academic Medicine, 72(2), 211–17CrossRefGoogle ScholarPubMed
Hoffman, C., Rice, D. P. and Sung, H. Y. (1996). Persons with chronic conditions: their prevalence and costs. Journal of the American Medical Association, 276(18), 1473–9CrossRefGoogle ScholarPubMed
Holmes, E. W., Burks, T. E., Dzau, V., Hindery, M. A., Jones, R. E., Kaye, C. I., Korn, D., Limbird, L. E., Marchase, R. B., Perlmutter, R., Sanfillipo, F. and Strom, B. L. (2000). Measuring contributions to the research mission of medical schools. Academic Medicine, 75(3), 303–13CrossRefGoogle ScholarPubMed
Institute of Medicine (2001). Crossing the Quality Chasm: a New Health System for the 21st Century. Washington, DC: National Academy Press
Johns, M. E. and Niparko, J. K. (1996). Averaging excellence out?Archives of Otolaryngology Head Neck Surgery, 122(10), 1839–44CrossRefGoogle ScholarPubMed
Jones, R. F. and Korn, D. (1997). On the cost of educating a medical student. Academic Medicine, 72(3), 200–10CrossRefGoogle ScholarPubMed
Kataria, S. (1998). The turmoil of academic physicians: what AMCs can do to ease their pain. Academic Medicine, 73(7), 728–30CrossRefGoogle Scholar
Korn, D. (1996). Reengineering academic medical centers: reengineering academic values?Academic Medicine, 71(10), 1033–43CrossRefGoogle ScholarPubMed
Ludmerer, K. M. (1999). Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care. New York: Oxford University Press
Lynch, J. (2001). Leveraging Leadership to Drive Growth at GE. Presentation to the Blue Ridge Academic Health Group
McKinlay, J. and Arches, J. (1985). Towards the proletarianization of physicians. International Journal of Health Services, 15(2), 161–95CrossRefGoogle ScholarPubMed
Medical Education Panel Survey (2000). MEPS HC-0068: 1996. Medical Conditions. Online at http://www.meps.ahrq.gov/catlist.htm
Nora, L. M., Pomeroy, C., Curry, T. E., Hill, N. S., Tibbs, P. A. and Wilson, E. A. (2000). Revising appointment, promotion, and tenure procedures to incorporate an expanded definition of scholarship: the University of Kentucky College of Medicine experience. Academic Medicine, 75(9), 913–24CrossRefGoogle ScholarPubMed
Pellegrin, K. L. and Arana, G. W. (1998). Why the triple threat approach threatens the viability of academic health centers. Academic Medicine, 73(2), 123–5CrossRefGoogle Scholar
Rein, M. F., Randolph, W. J., Short, J. G., Coolidge, K. G., Coates, M. L. and Carey, R. M. (1997). Defining the cost of educating undergraduate medical students at the University of Virginia. Academic Medicine, 72(3), 218–27CrossRefGoogle ScholarPubMed
Relman, A. S. (1994). The health care industry: where is it taking us? In The Nation's Health, 4th ed. P. R. Lee and C. L. Estes. eds. London: Jones and Bartlett Publishers
Rouan, G. W. and Wones, R. G. (1999). Rewarding teaching faculty with a reimbursement plan. Journal of General Internal Medicine, 6(14), 327–32CrossRefGoogle Scholar
Stewart, T. A. (1997). Intellectual Capital: the New Wealth of Organizations. New York: Doubleday
Sussman, A. J., Fairchild, D. G., Coblyn, J. and Brennan, T. A. (2001). Primary care compensation at an academic medical center: a model for the mixed-payer environment. Academic Medicine, 76(7), 693–9CrossRefGoogle ScholarPubMed
Wagner, E. H. (2000). The role of patient care teams in chronic disease management. British Medical Journal, 320(7234), 569–72CrossRefGoogle ScholarPubMed
Weissman, J. S. and MacDonald, E. A. (2001). Current findings on the financial status of academic health centers. Presentation to the Commonwealth Fund Task Force on Academic Health Centers Spring Meeting, April 27
Alexander, B., Davis, L. and Kohler, P. O. (1997). Changing structure to improve function: one academic health center's experience. Academic Medicine, 72(4), 259–268CrossRefGoogle ScholarPubMed
Blue Ridge Academic Health Group (1998). Academic Health Centers: Getting Down to Business. Washington, DC: Cap Gemini Ernst & Young US, LLC
Institute of Medicine (2001). Crossing the Quality Chasm: a New Health System for the 21st Century. Washington, DC: National Academy Pres
Alexander, B., Davis, L. and Kohler, P. O. (1997). Changing structure to improve function: one academic health center's experience. Academic Medicine, 72(4), 259–268CrossRefGoogle ScholarPubMed
Blue Ridge Academic Health Group (1998). Academic Health Centers: Getting Down to Business. Washington, DC: Cap Gemini Ernst & Young US, LLC
Institute of Medicine (2001). Crossing the Quality Chasm: a New Health System for the 21st Century. Washington, DC: National Academy Pres
Institute of Medicine (2001). Crossing the Quality Chasm: a New Health System for the 21st Century. Washington, DC: National Academy Press
Institute of Medicine (2001). Crossing the Quality Chasm: a New Health System for the 21st Century. Washington, DC: National Academy Press
Cooper, R. A. (1995). Perspectives on the physician workforce to the year 2020. Journal of the American Medical Association, 274(19), 1534–43CrossRefGoogle ScholarPubMed
Institute of Medicine (1999). To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press
Institute of Medicine (2001). Crossing the Quality Chasm: a New Health System for the 21st Century. Washington, DC: National Academy Press
Sheldon, G. F. (1998). Professionalism, managed care, and the human rights movement. Bulletin of the American College of Surgeons, 83, 14–33Google ScholarPubMed
Sheldon, G. F. and Kagarise, M. J. (2002). Surgical organizations in the 21st century. The American Journal of Surgery, 183(4), 338–44CrossRefGoogle ScholarPubMed
Stevens, R. A. (2001). Public roles for the medical professions in the United States: beyond theories of decline and fall. The Millbank Quarterly, 79(3), 327–53CrossRefGoogle Scholar

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  • Pursuing organizational and cultural change
    • By Michael A. Geheb, Professor of Medicine and Vice President Institutional Advancement at Oregon Health & Science University, Mark L. Penkhus, Senior Vice President and Chief Development Officer Sheridan Healthcorp, Peter O. Kohler, President Oregon Health & Science University, Arthur Garson, Vice President and Dean of the School of Medicine University of Virginia, Jonathan F. Saxton, Health Policy Analyst Emory University, Michael M. E. Johns, Executive Vice President Health Affairs at Emory University; Chief Executive Officer Robert W. Woodruff Health Sciences Center, George F. Sheldon, Professor of Surgery and Social Medicine and former Chair of Surgery University of North Carolina
  • Edited by Don Detmer, University of Virginia, Elaine Steen, University of Virginia
  • Book: The Academic Health Center
  • Online publication: 12 November 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511543487.006
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  • Pursuing organizational and cultural change
    • By Michael A. Geheb, Professor of Medicine and Vice President Institutional Advancement at Oregon Health & Science University, Mark L. Penkhus, Senior Vice President and Chief Development Officer Sheridan Healthcorp, Peter O. Kohler, President Oregon Health & Science University, Arthur Garson, Vice President and Dean of the School of Medicine University of Virginia, Jonathan F. Saxton, Health Policy Analyst Emory University, Michael M. E. Johns, Executive Vice President Health Affairs at Emory University; Chief Executive Officer Robert W. Woodruff Health Sciences Center, George F. Sheldon, Professor of Surgery and Social Medicine and former Chair of Surgery University of North Carolina
  • Edited by Don Detmer, University of Virginia, Elaine Steen, University of Virginia
  • Book: The Academic Health Center
  • Online publication: 12 November 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511543487.006
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Pursuing organizational and cultural change
    • By Michael A. Geheb, Professor of Medicine and Vice President Institutional Advancement at Oregon Health & Science University, Mark L. Penkhus, Senior Vice President and Chief Development Officer Sheridan Healthcorp, Peter O. Kohler, President Oregon Health & Science University, Arthur Garson, Vice President and Dean of the School of Medicine University of Virginia, Jonathan F. Saxton, Health Policy Analyst Emory University, Michael M. E. Johns, Executive Vice President Health Affairs at Emory University; Chief Executive Officer Robert W. Woodruff Health Sciences Center, George F. Sheldon, Professor of Surgery and Social Medicine and former Chair of Surgery University of North Carolina
  • Edited by Don Detmer, University of Virginia, Elaine Steen, University of Virginia
  • Book: The Academic Health Center
  • Online publication: 12 November 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511543487.006
Available formats
×