Education Leadership Conference
Academic health centers are shrouded in myths, said Elaine R. Rubin, PhD, vice president for policy and programs of the Association of Academic Health Centers. In a presentation at APA's 2009 Education Leadership Conference, Rubin set out to dismantle those misunderstandings by offering what she called an "Academic Health Centers 101."
Academic health centers, she explained, are accredited, degree-granting higher education institutions with a medical school and at least one other health professional program plus an owned or affiliated teaching hospital.
Psychology is under-represented in these centers, APA's Executive Director for Education Cynthia Belar, PhD, said later.
"Although there are a number of internships in academic health centers, there are only about 10 doctoral programs," Belar said. "Given the role of academic health centers in preparing the health work force in research and practice, psychology needs to be front and center in these endeavors."
Now academic health centers are facing new challenges, including rising costs, reduced resources and globalization—forces that are leading to more interdisciplinary practice, an increased focus on community-based research and other transformations at academic health centers.
Common misperceptions include:
• Myth #1: Academic health centers are ivory towers unconnected to their communities. "In reality, the centers are doers, not just dreamers," said Rubin. The University of California at Davis, for instance, is leading a statewide initiative to use video consultations to boost access to health care in rural parts of the state. The State University of New York Downstate Medical Center is developing a biotechnology institute that will bring jobs and educational opportunities to the Brooklyn waterfront. And the University of New Mexico is addressing health disparities by creating health extension offices in rural areas on the model of the agricultural extension program.
• Myth #2: The centers are only about medicine, because that's where most of the money goes. Not so, said Rubin. Academic health centers have a three-part mission of education, research and patient care. When it comes to patient care, centers are addressing patients' needs and expectations. At the University of Utah, for instance, administrators responded to patients' complaints about disorganized care by changing hiring and retention practices and other policies. "A year later, patients' letters show a 180-degree turnaround," said Rubin.
• Myth #3: Academic health centers are elitist. "Everyone thinks academic health centers are all very elite institutions only dedicated to research," said Rubin. Instead, these centers are often very diverse institutions—large and small—with a variety of programs and activities across three mission areas. They are often the largest employers in their city, state or even region. Members of Rubin's association have an average annual payroll of $430 million, with some exceeding $1 billion.
• Myth #4: The centers are very well-funded. The truth is these institutions have faced tremendous blows this year. Public institutions are seeing big cutbacks in state funding, while private institutions have suffered huge losses in their endowments and a dramatic drop-off in philanthropic donations. At the same time, the cost of education and patient care is rising. Patients are postponing elective procedures and even regular health care, a trend that affects centers' bottom lines as well as patients' health. Support for research is also threatened, Rubin said, adding that the influx of stimulus funding hasn't been enough to offset other reductions.
The transformation of academic health centers will continue as new trends take hold, said Rubin. These include a greater emphasis on cross-disciplinary collaboration and the creation of academic health centers worldwide that will compete with U.S. centers for brainpower, patients, products and research.
"I end here with a big unknown—health-care reform," said Rubin. "Whatever happens shouldn't undermine the three mission areas—education, research and patient care—of academic health centers."
Rebecca A. Clay is a writer in Washington, D.C.