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Darrell G. Kirch, M.D., President of the Association of American Medical Colleges, called for American medical schools to lead a transformation of American medicine, during a speech given at the Academy of Psychosomatic Medicine convention, Thursday, Nov. 11, 2010 in Marco Island, Florida.

“This isn’t working anymore,” he said of the U.S. medical system. He also remarked that the nation’s efforts toward health care reform were “whittled” so that “we passed a health insurance bill, not a health reform bill.” He noted that the Affordable Care Act is heavily modeled on health reform already implemented in Massachusetts, which only laid bare problems with medical care access.

The political system is gridlocked. The private sector has to look out for its own interests. “We’re on a path to failure,” he said, calling for American medical schools to take the lead for meaningful health care reform.

A convergence of events now makes a significant transformation of the American medical system not only possible, but necessary, he said. Medical education needs to change, he said, as it has traditionally been fact-oriented, based on a “shared delusion that we could know enough facts.” Medical education should re-gear toward teaching students how to process and use the abundance of information now available. Secondly, he spoke of a “mission shortfall,” and that despite advances in medical knowledge, better methods are not implemented. In part this is due to the third factor, which is the nation’s fiscal situation.

Health care is the epicenter of the nation’s financial crisis, he said, and the problem will only grow with an aging population who will want “four new titanium joints“ in order to continue skiing into their nineties. He spoke of the nation making choices between education and Medicaid, and that health care costs are causing the U.S. to be non-competitive.

Medical schools must lead the charge for a change in medical culture, toward one that is more collaborative, transparent, and patient-centered, Dr. Kirch said. He ended with a note of optimism, that if a few of key medical centers take leadership, then change will likely spread rapidly through the others.


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