Abstract
The health care system of the United States has been in a period of dramatic transformation since the passage of the Affordable Care Act in 2010, and the rate of change is accelerating. Historically, health care delivery was focused on the efforts of independent individual providers related to single patients, but the future will require interprofessional teamwork to achieve successful transformation. Academic health centers must identify nimble leaders who can harness the expertise of every team member to succeed in yielding the triple aim—better care for individuals, better health for populations, and lower overall cost. To create this change, there are several critical success factors for academic health center leaders, including creating a culture of collaboration, becoming “multipliers,” embracing innovation, adhering to core professional ethics, and working to promote resilience. Given their extensive training and predisposition to these skills, psychologists are well-positioned to serve as leaders in today’s academic health systems.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alberti, P. (2014). Community health needs assessments: Filling data gaps for population health research and management. eGEMs, 2, 1174. doi:10.13063/2327-9214.1174.
American Psychological Association. (2010) Ethical principles of psychologists and code of conduct. Washington, DC: American Psychological Association. Retrieved from http://www.apa.org/ethics/code/.
Association of American Medical Colleges. (2013). Navigating the new realities of academic medicine: Implications and opportunities for a sustainable future. Washington, DC: Association of American Medical Colleges.
Association of American Medical Colleges. (2015) 2014 AAMC annual development survey. Washington, D.C. Retrieved from https://www.aamc.org/data/developmentsurvey/
Association of American Medical Colleges. (2016a) [LCME Part I-b student financial aid questionnaire, academic years from 2002–2003 through 2005–2006, and tuition and student fees questionnaire, academic years from 2012–2013 through 2015–2016]. Unpublished raw data.
Association of American Medical Colleges. (2016b) Academic medicine in 2025: Notable trends and five future forces. Washington, D.C. Retrieved from https://members.aamc.org/eweb/DynamicPage.aspx?webcode=aamcstorelandingpage
Berwick, D. M., Nolan, T. W., & Whittington, J. (2008). The triple aim: Care, health, and cost. Health Affairs, 27, 759–769. doi:10.1377/hlthaff.27.3.759.
Bureau of Economic Analysis, Department of Commerce. (2016). Biomedical research and development price index. Washington, D.C.: Author. Retrieved from https://officeofbudget.od.nih.gov/gbipriceindexes.html
Burwell, S. M. (2015). Setting value-based payment goals—HHS efforts to improve U.S. health care. The New England Journal of Medicine, 372, 897–899. doi:10.1056/NEJMp1500445.
Carraccio, C. L., & Englander, R. (2013). From Flexner to competencies: Reflections on a decade and the journey ahead. Academic Medicine, 88, 1067–1073. doi:10.1097/ACM.0b013e318299396f.
Clayson, D. M., & Mensh, I. N. (1987). Psychologists in medical schools: The trials of emerging political activism. American Psychologist, 42, 859–862.
Detsky, A. S., & Garber, A. M. (2016). Uber’s message for health care. The New England Journal of Medicine, 374, 806–809. doi:10.1056/NEJMp1512206.
Garcia-Shelton, L., & Leventhal, G. (2005). Psychology’s adaptation to medical schools, teaching hospitals, and academic medical centers: The role of academic medicine organizations. Journal of Clinical Psychology in Medical Settings, 12, 221–234. doi:10.1007/s10880-005-5741-8.
Gellis, Z. D. (2001). Job stress among academic health center and community hospital social workers. Administration in Social Work, 25, 17–33. doi:10.1300/J147v25n03_02.
Grigsby, R. K., Hefner, D. S., Souba, W. W., & Kirch, D. G. (2004). The future-oriented department chair. Academic Medicine, 79, 571–577. Retrieved from http://journals.lww.com/academicmedicine/Fulltext/2004/06000/The_Future_Oriented_Department_Chair.14.aspx.
Griner, P.F. (2013) Burnout in health care providers. Integrative Medicine, 12, 22–24. Retrieved from http://search.proquest.com/docview/1367579047?accountid=45791.
Hamel, M. B., Blumenthal, D., Abrams, M., & Nuzum, R. (2015). The affordable care act at 5 years. The New England Journal of Medicine, 372, 2451–2458. doi:10.1056/NEJMhpr1503614.
Hong, B. A., & Leventhal, G. (2004). Partnerships with psychiatry and other clinical disciplines: A key to psychology’s success in U.S. medical schools. Journal of Clinical Psychology in Medical Settings, 11, 135–140. doi:10.1023/B:JOCS.0000025725.81087.21.
Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative. Retrieved from http://www.aacn.nche.edu/education-resources/ipecreport.pdf
Kahn, M. J., Maurer, R., Wartman, S. A., & Sachs, B. P. (2014). A case for change: Disruption in academic medicine. Academic Medicine, 89, 1216–1219. doi:10.1097/ACM.0000000000000418.
Kirch, D. G., Mitchell, K., & Ast, C. (2013). The new 2015 MCAT: Testing competencies. JAMA, 310, 2243–2244. doi:10.1001/jama.2013.282093.
Kirch, D. G., & Vernon, D. J. (2009). The ethical foundation of American medicine: In search of social justice. JAMA, 301, 1482–1484. doi:10.1001/jama.2009.456.
Kivlahan, C., Orlowski, J. M., Pearce, J., Walradt, J., Baker, M., & Kirch, D. G. (2016). Taking risk: Early results from teaching hospitals’ participation in the Center for Medicare and Medicaid Innovation Bundled Payments for Care Improvement Initiative. Academic Medicine, 91, 936–942. doi:10.1097/ACM.0000000000001121.
Lineen, J. (2014). Hospital consolidation: “Safety in numbers” strategy prevails in preparation for a value-based marketplace. Journal of Healthcare Management, 59, 315–317.
Mallon, W. T., & Grigsby, R. K. (2016). Leading: Top skills, attributes, and behaviors critical for success. Washington, D.C.: Association of American Medical Colleges.
Manderscheid, R., & Kathol, R. (2014). Fostering sustainable, integrated medical and behavioral health services in medical settings. Annals of Internal Medicine, 160, 61–65. doi:10.7326/M13-1693.
Mann, K., Gordon, J., & MacLeod, A. (2009). Reflection and reflective practice in health professions education: A systematic review. Advances in Health Sciences Education, 14, 595–621. doi:10.1007/s10459-007-9090-2.
Mitchell, K., Lewis, R. S., Satterfield, J., & Hong, B. A. (2016). The new Medical College Admission Test: Implications for teaching psychology. American Psychologist, 71, 125–135. doi:10.1037/a0039975.
Prober, C. G., & Heath, C. (2012). Lecture halls without lectures – A proposal for medical education. New England Journal of Medicine, 366, 1657–1659. doi:10.1056/NEJMp1202451.
Rozensky, R. H. (1991). Psychology, politics, and hospitals. In J. J. Sweet, R. H. Rozensky, & S. M. Tovian (Eds.), Handbook of clinical psychology in medical settings (pp. 59–79). New York: Plenum Press.
Rozensky, R. H. (2012). Psychology in academic health centers: A true healthcare home. Journal of Clinical Psychology in Medical Settings, 19, 353–363. doi:10.1007/s10880-012-9312-5.
Shanafelt, T. D., Hasan, O., Dyrbye, L. N., Sinsky, C., Satele, D., Sloan, J., & West, C. P. (2015). Changes in burnout and satisfaction with work-life balance in physicians and the general U.S. working population between 2011 and 2014. Mayo Clinic Proceedings, 90, 1600–1613. doi:10.1016/j.mayocp.2015.08.023.
Slavin, S. J., Schindler, D. L., & Chibnall, J. T. (2014). Medical student mental health 3.0: Improving student wellness through curricular changes. Academic Medicine, 89, 573–577. doi:10.1097/ACM.0000000000000166.
Substance Abuse and Mental Health Services Administration. (2015) Behavioral health barometer: United States, 2015. HHS Publication No. SMA–16–Baro–2015. Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from http://www.samhsa.gov/data/sites/default/files/2015_National_Barometer.pdf
U.S. Department of Health and Human Services. (2015) CMS finalizes bundled payment initiative for hip and knee replacements [Press Release]. Retrieved from: http://www.hhs.gov/about/news/2015/11/16/cms-finalizes-bundled-payment-initiative-hip-and-knee-replacements.html
Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D. (2004). Nurse burnout and patient satisfaction. Medical Care, 42, 1157–1166. doi:10.1097/01.mlr.0000109126.50398.5a.
Wiseman, L., Bradwejn, J., & Westbroek, E. M. (2014). A new leadership curriculum: The multiplication of intelligence. Academic Medicine, 89, 376–379. doi:10.1097/ACM.0000000000000146.
Wiseman, L., & McKeown, G. (2010). Multipliers: How the best leaders make everyone smarter. New York: Harper Collins.
Yedidia, M. J. (1998). Challenges to effective medical school leadership: Perspectives of 22 current and former deans. Academic Medicine, 73, 631–639.
Acknowledgments
The authors thank Kate Petelle for her editorial assistance, and Eric Lui and Diane Cassidy for their technical assistance in the preparation of this manuscript. This report received no funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Darrell G. Kirch and Cori E. Ast declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human participants or animals performed by any of the authors.
Rights and permissions
About this article
Cite this article
Kirch, D.G., Ast, C.E. Health Care Transformation: The Role of Academic Health Centers and Their Psychologists. J Clin Psychol Med Settings 24, 86–91 (2017). https://doi.org/10.1007/s10880-016-9477-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10880-016-9477-4