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P&S Journal

P&S Journal: Fall 1995, Vol.15, No.3
Changing Times in Academic Medicine: A Message from the Dean

These are extraordinary times in academic medicine. On the one hand, science and research are blossoming, both nationally and at Columbia. We continue to make major scientific advances and find new and better ways to detect and treat disease. On the other hand, the foundations of support for our programs of clinical care, education, and research are being challenged. Managed care is changing the way we practice medicine and altering revenue streams. Budget-conscious governments have cut Medicaid reimburse ment. Reductions in Medicare seem imminent. Research funding is threatened by similar forces concerned with reducing government programs of all kinds. We face a great deal of change and many unknowns. We are not alone; every academic medical center in the country faces the same uncertainties.

Columbia-Presbyterian Medical Center has enviable strength to contend with the challenges facing us. Our name and our research volume place us among the very top academic medical centers. Applications for our educational programs have been steadily increa sing to record numbers, and the students are among the best in the country. We have a new curriculum that maintains our commitment to quality and substance in training while preparing students for a rapidly changing health-care environment.

Our Audubon research park, with the first building completed and the second under construction, will provide new research facilities as well as new venues for faculty research activities. Our faculty practice plan, which has now reached $180 million, prov ides a framework for continuing development of patient-care capabilities. The physicians' organization, the Columbia-Presbyterian Physician Network, is growing in strength and using collaboration and teamwork to deal with the growing need to establish gro up efforts in clinical care.

Much is being done to counter the worst effects of the new conditions. For instance, Columbia is working closely with other institutions to inform national leaders about the importance of academic medicine. We are having success in persuading many policy- makers to support academic medicine and biomedical research. At the state level, we worked with other centers to moderate some of the prospective cuts that would have been most onerous for our clinical, educational, and research programs. We are also expl oring new strategies to meet the new conditions. The objective in all possible scenarios is the same: to sustain the strong medical center we have now and to continue to build its leadership in academic medicine, while adjusting to new circumstances and r ealities in health care delivery. We are working increasingly closely with Presbyterian Hospital to enhance cooperation between the two institutions, with the objective of having a more unified medical center. Those talks have also included the possibilit y of strengthening our ties to St. Luke's-Roosevelt. A formal set of conversations is being undertaken in that regard among Columbia University, Presbyterian Hospital, and St. Luke's-Roosevelt Hospital. We have had conversations with other academic medica l centers regarding partnerships, including Mount Sinai, NYU Medical Center, and Cornell/New York Hospital Medical
Sincerely,

Herbert Pardes, M.D.
Vice President for Health Sciences and


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