Medicine, Machines, and Medical Education.

While advances in science and technology continue to be at the forefront of the evolution of medical practice, the 21st century is also undergoing a unique and profound cultural shift that is changing the very nature of what it means to be a medical professional, namely humankind's transition to an information-based internet society. Medical care will increasingly depend on computer-generated probabilities guided and supported by a growing variety of individuals in health care-related professions, including statisticians, technologists, and information managers. Perhaps the biggest challenge to the profession will come from the erosion of professional autonomy, driven by smart machines, social networks, and internet search engines.

The Empirical Challenge of 21st-Century Medical Education.

Medical education is at a crossroads. Facing challenges wrought by science and technology as well as societal change, the curriculum is increasingly out of synch with new needs in teaching content and medical practice. The path to significant curricular reform is difficult because of a variety of factors, including deeply entrenched values, the natural resistance to change, and the accreditation process.

Reimagining Medical Education in the Age of AI.

Available medical knowledge exceeds the organizing capacity of the human mind, yet medical education remains based on information acquisition and application. Complicating this information overload crisis among learners is the fact that physicians' skill sets now must include collaborating with and managing artificial intelligence (AI) applications that aggregate big data, generate diagnostic and treatment recommendations, and assign confidence ratings to those recommendations. Thus, an overhaul of medical school curricula is due and should focus on knowledge management (rather than information acquisition), effective use of AI, improved communication, and empathy cultivation.

Medical Education Must Move From the Information Age to the Age of Artificial Intelligence.

Noteworthy changes coming to the practice of medicine require significant medical education reforms. While proposals for such reforms abound, they are insufficient because they do not adequately address the most fundamental change-the practice of medicine is rapidly transitioning from the information age to the age of artificial intelligence. Increasingly, future medical practice will be characterized by: the delivery of care wherever the patient happens to be; the provision of care by newly constituted health care teams; the use of a growing array of data from multiple sources and artificial intelligence applications; and the skillful management of the interface between medicine and machines.

Health Reform and Academic Health Centers: Commentary on an Evolving Paradigm.

The Patient Protection and Affordable Care Act (ACA), both directly and indirectly, has had a demonstrable impact on academic health centers. Given the highly cross-subsidized nature of institutional funds flows, the impact of health reform is not limited to the clinical care mission but also extends to the research and education missions of these institutions. This Commentary discusses how public policy and market-based health reforms have played out relative to expectations.

A case for change: disruption in academic medicine.

Disruptive technologies allow less expensive and more efficient processes to eventually dominate a market sector. The academic health center's tripartite mission of education, clinical care, and research is threatened by decreasing revenues and increasing expenses and is, as a result, ripe for disruption. The authors describe current disruptive technologies that threaten traditional operations at academic health centers and provide a prescription not only to survive, but also to prosper, in the face of disruptive forces.

Resource allocation in academic health centers: creating common metrics.

Optimizing resource allocation is essential for effective academic health center (AHC) management, yet guidelines and principles for doing so in the research and educational arenas remain limited. To address this issue, the authors analyzed responses to the 2007-2008 Association of Academic Health Centers census using ratio analysis. The concept was to normalize data from an individual institution to that same institution, by creating a ratio of two separate values from the institution (e.

The role of academic health centers in addressing social responsibility.

Despite the many successes achieved by academic health centers and the significant attention paid to the importance of the impact of social determinants on health, a broader movement of the academic health center community to share best practices and standardize these efforts across institutions and communities has not taken hold. The "guild mentality" of the health professions, the existing university/academic health center structure, regulation and accreditation, and misaligned incentives in the health care system all inhibit the development of this movement. In this article, we propose a new model for how the academic health center community might better address the social determinants of health.

Commentary: Academic health centers: the compelling need for recalibration.

Although academic health centers (AHCs) represent a unique combination of teaching, research, and patient care, it is no longer enough to say that their missions are solely education, research, and patient care. Rather, these "missions" must be viewed as functions that enable institutions to achieve their overarching mission: the improved health and well-being of their communities. Focusing more sharply on this goal requires a recalibration of the AHC enterprise such that education is more explicitly linked to societal needs, research to health, and patient care to specific community and regional needs.

Implementing a simpler approach to mission-based planning in a medical school.

Changes in the education, research, and health care environments have had a major impact on the way in which medical schools fulfill their missions, and mission-based management approaches have been suggested to link the financial information of mission costs and revenues with measures of mission activity and productivity. The authors describe a simpler system, termed Mission-Aligned Planning (MAP), and its development and implementation, during fiscal years 2002 and 2003, at the School of Medicine at the University of Texas Health Science Center at San Antonio, Texas. The MAP system merges financial measures and activity measures to allow a broad understanding of the mission activities, to facilitate strategic planning at the school and departmental levels.

Screening for carotid artery disease in the general public.

BACKGROUND: Screening for various diseases is now being offered to the public in settings other than their physicians' office, often using expensive and sophisticated technology. Little is known about how patients decide to participate in such programs, whether they understand the implications of a positive or negative test, or if their primary care physician is involved in the decision to screen. METHODS: We surveyed a cohort of patients who participated in a free carotid artery screening using Doppler ultrasound at a tertiary care academic medical center.

Revisiting the idea of a national center for health professions education research.

The need for a national center for health professions education research is more compelling today than when originally proposed 15 years ago. There is a general consensus as to the need for better assessment of the educational outcomes of U.S.

Perceptions of medical school deans and state medical society executives about physician supply.

Context: Physician shortages are appearing, yet controversy about their significance and uncertainty about their remedy exist.

Objectives: To sample the perceptions of medical school deans and state medical society executives about the adequacy of physician supply, to determine the perceived impact of any shortages on medical schools, and to assess the capacity of medical schools to expand.

Design, Setting, And Participants: Medical school deans in the United States and Puerto Rico were surveyed by means of a structured questionnaire, and officials of US state medical societies were queried by means of open-ended telephone interviews.