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Articles by Darrell G. Kirch
National Plan for Health Workforce Well-Being
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Enduring truths in an age of disruption
Change is a constant in life, both personally and professionally. Sometimes, though, changes feel so disruptive that we may fundamentally question who we are and where we are heading. Today, as we face great uncertainty created by tumultuous change in health care and society at large, a set of core beliefs can help us remain true to our values and missions even as we are buffeted by conflicting forces.
Training the next generation of doctors is critical to improving Nevadans’ health
By Dr. Darrell Kirch Tuesday, July 9, 2019 | 2 a.m. Not long ago, I had the privilege of making my first visit to the new UNLV School of Medicine. It was immensely gratifying to witness firsthand the leadership, faculty and students embracing change — in the way medical students are taught and trained and in the school’s commitment to reimagining the way tomorrow’s physicians will care for their future patients.
Supporting the Next Generation as the Physician Shortage Becomes Reality
This month, the AAMC released our fourth annual study of physician supply and demand, modeling a wide range of health care and policy scenarios including payment and delivery reform, increased use of advanced practice nurses and physician assistants, and delays in physician retirements. The data are troubling. Under every likely scenario, this year’s workforce estimates project a shortage of between 42,600 and 121,300 physicians by 2030.
Addressing racism and mistreatment in academic medicine
The recent news stories of unprofessional, unethical, and outright racist behavior in academic medicine are deeply troubling. While our community has responded, I am deeply concerned that these incidents may be increasing. In a time when growing incivility and discord are feeding divisiveness all around us, it is essential that all of us in the academic medicine community, from our leaders to our learners, hold ourselves to the highest moral and ethical standards.
Building a framework for clinician well-being and resilience
In July, the National Academy of Medicine (NAM) Action Collaborative on Clinician Well-Being and Resilience convened for its first public meeting since it began in early 2017. The NAM Action Collaborative was established out of a growing national awareness that the epidemic of burnout, as well as depression and suicide, has worsened significantly across the health professions in recent years.
Truth, Science, and the American Dream
The following are abridged remarks delivered to more than 4,500 participants at Learn Serve Lead 2017: The AAMC Annual Meeting, in Boston on Nov. 5. Recently, one particular issue has been weighing heavily on my mind. That issue is the threat to truth. The kind of threat that comes from opinion masquerading as fact, especially on the web and in social media. The threat of confusing “fake news” with real news. The threat that exists when bias and fear distract and distort a debate.
Looking Back and Moving Forward—75 Years of the LCME
This month, we are celebrating the 75th anniversary of the Liaison Committee on Medical Education (LCME), the accreditation body for medical schools. When I became the dean at the Medical College of Georgia, I was only vaguely aware of the LCME, having spent the early part of my career at the National Institutes of Health.
Academic Medicine and Social Justice
I have been reflecting on the recent events in Ferguson, Mo., and Staten Island, N.Y., and the resulting national conversation about interactions among minority communities and the police. Both deaths were avoidable tragedies that should have sparked serious and productive dialogue to address the underlying social issues. Like many of you, I was disheartened when, instead, strident, competing narratives developed in the wake of these events—with people often talking past one another.
Spiraling drug costs and threats to the 340B program hurt patients
We are in the midst of a troubling shift in health care economics. The Centers for Medicare and Medicaid Services (CMS) forecast that spending for retail prescription drugs will become the fastest growing health care expense in the United States and outpace spending growth for all other medical and health care segments over the next decade. Yes, more than hospital care or physician and clinical services. The skyrocketing cost of pharmaceuticals is deeply concerning.
When Physicians Become Patients
Editor’s Note: This column was first published on January 31, 2018, as part of the LinkedIn series “Hard Cases.” After I completed my residency training in psychiatry, I served as a research fellow at the National Institute of Mental Health (NIMH) in Washington, D.C. As an NIMH fellow, I maintained a limited private practice, and because of my research work, I was often referred more complex and difficult cases.
In Search of Community
Over the last five days, the community of academic medicine gathered in Seattle to share insights and search for solutions to some of the most complex health challenges facing our country. Returning to Seattle has special meaning for me, because 10 years ago, I delivered my first annual meeting address in Seattle as president and CEO of the AAMC.
Graduate Medical Education: An Investment in Our Future
On March 18, the AAMC joined medical students, faculty, and medical school administrators around the country in celebrating Match Day—the annual event at which medical students learn where they will complete their residency training. I know we all are delighted to see students who have worked so hard for four years in medical school take the next step toward achieving their dreams.
“That’s when I knew I wanted to be a doctor”
Every June, I am grateful to be invited to commencement ceremonies at medical schools around the country. For the graduates, as well as their families and teachers, it is a day of unmitigated joy and celebration. So little has changed in that regard since I was in medical school. Despite the increased turmoil in our health care system today, these students are every bit as enthusiastic as I was to complete their classroom studies and begin the next phase of their training in patient care.
Creating Learning Environments That Promote Physician Resilience
When I was a medical student and resident, the culture of academic medicine was hierarchical and individualistic. This culture made it difficult to acknowledge and understand the problems that were leading to stress and burnout among learners, educators, and practicing physicians and scientists. It saddens me to think about how we tolerated corrosive and disrespectful interactions, assuming they were natural for a profession that is stressful and an educational process that is rigorous.
Improving the Transition to Residency
Darrell G. Kirch, MD, AAMC President and CEO Updated 08/22/2017 to include new resource, Toolkits for the 13 Core Entrustable Professional Activities for Entering Residency. I, like so many physicians, vividly remember my first day as a resident. Once again this year, on July 1, first-year medical residents across the country will report to their residency programs to begin the next phase of their careers.
Looking Back and Moving Forward-75 Years of the LCME
This month, we are celebrating the 75th anniversary of the Liaison Committee on Medical Education (LCME), the accreditation body for medical schools. When I became the dean at the Medical College of Georgia, I was only vaguely aware of the LCME, having spent the early part of my career at the National Institutes of Health.
Our Concerned Community
Each spring, many of our AAMC constituent groups and councils hold meetings to discuss academic medicine’s current challenges and opportunities. Academic medicine is a large tent, and the AAMC represents many individuals with many different roles at our institutions, from physicians and researchers, to students and faculty, to deans and CEOs. But while the breadth of experiences and perspectives in academic medicine is broad, certain challenges are felt across our entire community.
The Principles That Guide Academic Medicine
With the inauguration of our new president and the convening of the 115th Congress, we have entered a new era of uncertainty in health care. As expected, one of the first actions by the new Congress was taking steps to repeal the Affordable Care Act (ACA), though when and how the law will be replaced is unclear. Much remains to be seen about how this new direction will affect academic medicine and U.S. health care writ large.
A Landmark for Women in Medicine
In 1973, the year I started medical school, women constituted only a small percentage of all medical students. My own class at the University of Colorado reflected this trend. I realize, in hindsight, how unaware my male classmates and I were of the many barriers our female colleagues had overcome to be there—from unconscious bias to outright sexism—and how they continued to experience more of the same in medical school and residency training.
A Leadership Forum on Diversity and Inclusion
In June, approximately 70 academic medicine leaders representing all AAMC affinity groups gathered in Washington, D.C., for our 2017 Leadership Forum, “Achieving Diversity, Inclusion, and Equity in Academic Medicine.” Six months previously, at Learn Serve Lead: The AAMC Annual Meeting, Joan Reede, MD, professor of medicine and dean for diversity and community partnership at Harvard Medical School and chair of the AAMC Group on Diversity and Inclusion, challenged AAMC group leaders to view the...
Academic medicine leads efforts to address the opioid epidemic
Tragically, 130 people die every day in this country from an opioid overdose. About 2 million Americans were living with opioid addiction in 2017, according to the Centers for Disease Control and Prevention. Medical schools and teaching hospitals see the effects of the epidemic every day in their communities. When the mortality rate for opioid use disorder started to accelerate in 2013, concerns were raised that the problem somehow reflected a failure in medical education.
Caring for Ourselves, Caring for Each Other
Like many of my colleagues, I have seen firsthand how burnout and depression can interrupt a career in medicine. As a psychiatrist, I have personally experienced the tragedy of suicide. Two years ago, following the 2014 deaths by suicide of two residents in New York City, I spoke about the importance of resilience at the AAMC annual meeting in Chicago.
Jimmy Kimmel Highlights the Value of Teaching Hospitals
Darrell G. Kirch, MD, AAMC President and CEO Late-night television is characterized by light entertainment and comedy. On May 1, 2017, however, Jimmy Kimmel opened his late-night show with an emotional monologue about his newborn son, Billy, who was born with a serious heart condition.
Leading in challenging times
This spring, I joined fellow leaders in academic medicine for our annual AAMC council meetings—the Council of Deans and Council of Teaching Hospitals and Health Systems combined meeting in Phoenix, Ariz., and the Council of Faculty and Academic Societies meeting in Chicago, Ill. I always value these gatherings for the opportunities they present to share best practices, network with colleagues, and hear fresh perspectives from peers across the country.
Philanthropy Bonds Institutions and Communities
Darrell G. Kirch, MD, AAMC President and CEO This fall, I was honored to attend the opening of a new interprofessional medical education building at one of our member institutions. The new building featured a design that reflected the effort to build a community among health professionals, including physicians, athletic trainers, scientists, physician assistants, and physical and occupational therapists.
Core Competencies and the Heart of Learning
As a medical school dean, I always enjoyed the month of September. First-year medical students gather on campus, full of excitement and ready to begin their medical careers. Medical students further along in their training are returning from summers spent conducting research, working in a clinical environment, or studying for the USMLE Step 1 exam.
Crossing the Inequality Chasm
Editor’s Note: The following column is adapted from Dr. Kirch’s address at Learn Serve Lead 2015: The AAMC Annual Meeting. In a 2001 landmark report, Crossing the Quality Chasm, the Institute of Medicine recognized equity as a central pillar of quality care. Nearly 15 years later, we continue to examine the ways in which racial, social, and economic inequality affect society and health.
What Does the Future Hold for Academic Medicine in a World of Health System Mergers and Acquisitions?
Spring finally arrived in Washington, and for the AAMC, that meant not only cherry blossoms and warmer weather, but also the opportunity for us to gather with our constituents at our various affinity group spring meetings. In March, I attended the Council of Deans and Council of Teaching Hospitals and Health Systems combined meeting, where we discussed the dramatic transformation occurring at our medical schools and teaching hospitals and the implications for the future of academic medicine.
Scaling the mountaintops of academic medicine
This column is based on Darrell G. Kirch’s final address, delivered at Learn Serve Lead 2018: The AAMC Annual Meeting in Austin earlier this month. It is truly humbling — and an incredible honor — to have served as only the fourth AAMC president and CEO since that role was created in 1969. Drs. John A.D. Cooper, Robert Petersdorf, and Jordan Cohen are the giants on whose shoulders I stand.
The Tragedy in Las Vegas
It is hard to find words to adequately convey our sorrow for the people who were killed or injured by the horrific shooting in Las Vegas last week. Our thoughts and prayers go out to them and their families. The University Medical Center Southern Nevada (UMC) received many of the most critically injured patients. A teaching hospital, UMC includes the state’s only Level 1 trauma center and is a major training site for the next generation of Nevada’s physicians and health care professionals.
In Search of Community
Darrell G. Kirch, MD, AAMC President and CEO Over the last five days, the community of academic medicine gathered in Seattle to share insights and search for solutions to some of the most complex health challenges facing our country. Returning to Seattle has special meaning for me, because 10 years ago, I delivered my first annual meeting address in Seattle as president and CEO of the AAMC.
Thinking of Our Colleagues Affected by Hurricane Harvey
Darrell G. Kirch, MD, AAMC President and CEO The AAMC is extremely proud of our colleagues in Texas and Louisiana who are working together around-the-clock to care for their patients and maintain the vital services they provide to their communities devastated by Hurricane Harvey.
10 wishes for the new year
With a new year comes reflection about where we are and where we aspire to be. In 2019, I see tremendous potential for academic medicine to achieve even greater things. Over the last few years, many of our institutions have become anchors in their communities. They identified gaps in community health and provided services beyond their walls to aid victims of gun violence, care for the homeless, bring health services to underserved urban and rural areas, and help stem the opioid epidemic.
High quality, affordable health care is the right of every American
As I approach the end of my tenure at the AAMC, I’m often asked about the high point of my 13 years as president and CEO. Without reservation, I reply that it was when the AAMC made its final push to endorse and secure passage of the Affordable Care Act (ACA). I was proud that the AAMC Board of Directors stepped up to take a strong public stand on this legislation while many other organizations stayed on the sidelines waiting to see how the politics would play out.
What Americans think about medical schools and teaching hospitals
We all have been on an airplane or at a social event where the person next to you asks what you do. I answer that I work with an association that represents medical schools and teaching hospitals. Often, people have not heard of the AAMC, but will share a positive experience they had at one of our institutions. It is always gratifying to hear the praise, although I know that anecdotal information is not a scientific way to gauge how we are doing.
Thinking of Our Colleagues Affected by Hurricane Harvey
The AAMC is extremely proud of our colleagues in Texas and Louisiana who are working together around-the-clock to care for their patients and maintain the vital services they provide to their communities devastated by Hurricane Harvey.
In the Search for Measures that Matter, Star Ratings Miss the Mark
From restaurant and movie reviews to websites that rate professors and real estate agents, it sometimes seems as if every aspect of our lives is facilitated by reviews and ratings. Ratings can be a useful shortcut when deciding where to go to dinner or what movie to see, but the complex nature of health care makes developing a reliable ratings scale for hospitals a fraught proposition.
When Physicians Become Patients
After I completed my residency training in psychiatry, I served as a research fellow at the National Institute of Mental Health (NIMH) in Washington, D.C. As an NIMH fellow, I maintained a limited private practice, and because of my research work, I was often referred more complex and difficult cases. Among the patients who stand out most clearly, as I look back, were the physicians I treated for stress, anxiety, and depression.
To Care Is Human - Collectively Confronting the Clinician-Burnout Crisis
The ethical principles that guide clinical care — a commitment to benefiting the patient, avoiding harm, respecting patient autonomy, and striving for justice in health care — affirm the moral foundation and deep meaning underlying many clinicians’ view of their profession as a worthy and gratifying calling.
Addressing the Physician Shortage: The Peril of Ignoring Demography
Does the United States have enough physicians?—No. The United States faces a serious physician shortage that is likely to worsen in the coming decade without multifaceted intervention. At the same time, the US health care system is in a period of marked uncertainty, and many questions are on the horizon—from the future of health insurance coverage to how scientific discoveries will revolutionize medicine in the coming decades.
Modern Healthcare
When choosing a hospital, patients need and deserve meaningful and transparent information about the quality of care an institution will provide.But that is not what they got when the CMS recently released its new hospital overall star ratings on the Hospital Compare website.Instead of providing useful information, the new ratings paint a confusing and conflicting picture of the quality of U.S. hospital care because of a deeply flawed methodology that ignores important differences in the...
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