Letters from Leadership
I remember well the warm welcome I received last January in the Flaum Atrium on the day University of Rochester President Joel Seligman announced that I would return from my injury and work again as chief executive officer of the University of Rochester Medical Center (URMC).
Much has happened in a year, and I especially want to tell you about an exciting program that we announced last month at URMC and our School of Medicine and Dentistry. It marks the next phase of an initiative that we’ve been working on for several years, but with intense focus over the last year.
My experiences as a patient were a revelation, an undeniable reminder of the critical importance of providing compassionate, attentive care. I was impressed by the caregivers who had the courage to genuinely engage me and my wife, Mary, in conversations about our fears and concerns. As CEO, I’ve been determined to find a way to provide patient-and family-centered care more consistently across URMC. Our goal is to care with our patients, rather than for our patients. In addition, we need to engage families in the treatment plans for our patients. Equally important, we need to foster an environment of caring for each other in which teamwork and a shared vision is the norm.
Health systems that support patient-and-family-centered care with involvement in decision-making achieve improved quality, safety, efficiency and greater satisfaction for patients and staff. Given the pressures that all health care providers are currently facing, this explains why so many health care organizations are now embracing patient- and family-centered care. Touted by the Institute for Health Care Improvement, the Agency for Health Care Research and Quality, the University HealthSystem Consortium and others, virtually every major health organization is on a similar journey.
Fortunately, Rochester has considerable advantages, not the least of which is our heritage with the biopsychosocial model. This model has been taught in our medical school for more than 30 years, and has imbued two generations of students and faculty with a deep appreciation of the humanistic elements of health care. Consequently, we have a cadre of nationally prominent clinician-scientists who practice and teach patient-and-family-centered care. Led by Steve Goldstein, CEO of Strong Memorial Hospital and Highland Hospital, Jackie Beckerman, director of Strong Commitment, and Jean Joseph, M.D., Patient-and Family-Centered Care medical director, we have developed a comprehensive approach to implementing this next generation of the biopsychosocial model throughout URMC.
Just last month, we held a series of Town Hall meetings to introduce the concepts developed by our core teams with the entire URMC faculty and staff. The response has been inspiring. Everyone involved in patient care—physicians, nurses, transporters, food service and environmental service workers alike—is focusing on interactions with colleagues, patients and families. There is a palpable energy around this new way of providing care. Everyone is becoming passionate about living our brand, “Medicine of the Highest Order.”
We’re already seeing that patient- and family-centered care is rewarding in myriad ways. It builds patient loyalty, improves outcomes and increases efficiency. Not surprisingly, those caregivers who score highest on patient satisfaction surveys report having the highest level of career fulfillment. At a time when caregivers feel the pressure of so much change in health care, patient-and-family-centered care is not “just one more thing we need to do,” it is “the thing that we must do.”
This past year marked the centennial anniversary of the revolutionary report by Abraham Flexner for the Carnegie Foundation for the Advancement of Teaching that criticized the quality of most American medical schools.
Flexner found most curriculums offered future physicians little education in science. He proposed basing medical schools at universities, setting high entry and graduation standards, establishing clinical as well as academic settings where students would learn, and facilitating faculty research.
Our School of Medicine and Dentistry grew out of this report. Flexner met with Rush Rhees, who was then the president of the University of Rochester, and with businessman and philanthropist George Eastman, urging them to create a school that would truly educate and prepare physicians and scientists.
Our history shows we have lived up to Flexner’s call. The feature articles in this issue of Rochester Medicine illustrate how we continue to answer that call.
You will read about the Dean’s Teaching Fellowship program that builds the educational skills of our faculty and also helps renew our curriculum. Recipients of the fellowship, to name only a few, helped create a training program for those who care for women and their babies in high-risk deliveries, built a comprehensive assessment of clinical competence in emergency medicine, developed a standardized patient program for third-year surgery students and demonstrated the value of medical student peer assessments.
J. Edward Puzas, Ph.D., is the Donald and Mary Clark Professor of Orthopaedics, the School of Medicine and Dentistry’s senior associate dean for basic research and an alumnus of the School. His research into the effects of lead in bone, as described in this issue, not only demonstrates our commitment to research but also our drive to link our research to clinical problems. “Whenever we do experiments, we are always thinking about how to take what we find and apply it to cure a problem in humans,” Ed says.
In his report 100 years ago, Flexner recognized changes coming to medicine through science. In the past, he wrote, physicians were responsible to a patient and perhaps the patient’s family. “But the physician’s function is fast becoming social and preventive,” Flexner said. “Upon him society relies to ascertain . . . the conditions that prevent disease and make positively for physical and moral well-being.”
So Flexner would recognize the importance of the fourth core mission of the Medical Center, community health. While the official naming of a fourth core mission did not occur until 2004, the commitment to community health by our Medical Center and the School of Medicine and Dentistry goes back decades.
In this issue of Rochester Medicine, we begin a series of articles on our community health programs. Our Medical Center and the School of Medicine and Dentistry have more than 300 of these programs. You also can find our community commitment in the research of Ed Puzas and other members of our faculty. These are all reasons why I am confident that, if Flexner could return, he would give us high grades.
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Simulation and Medical Education
Linda Spillane, M.D., assistant dean for medical simulation at the School of Medicine and Dentistry, discusses the value of simulation in medical education and its future at the School of Medicine and Dentistry.
School of Medicine and Dentistry students who want to improve their language skills and expand their knowledge of Latino culture to develop the skills necessary to work with Spanish-speaking patients can choose a unique certification program, the Latino Health Pathway, which includes electives, community outreach activities and research projects.
An alumnus and his camera with soldiers in Afghanistan
Barry M. Goldstein, M.D., Ph. D., (M ’81, PhD ’82), has become a student of soldiers under pressure, recording what he sees with his camera. See his most recent collection of photos called Battle Mind, from a stay in Afganistan with a reserve unit that oversees mental health caare for soldiers on deployment.