In Search of Community

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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. My topic that year was “In Search of the Public Good,” a speech about the need for a major national recommitment to the public goods of academic medicine—educating the health care workforce, leading scientific discovery, and caring for our patients. Unfortunately, in the years that followed, our nation plunged into the Great Recession and our medical schools and teaching hospitals were forced to contend with reductions in support that have affected all of our mission areas. While our economy has recovered, a national reinvestment in the public goods of academic medicine has not come to pass.
 

As we gathered once again in Seattle this year, I found myself reflecting not only on the changes to our country over the last decade that have decreased our national commitment to supporting the public goods of education, research, and health care, but also on what our community can do to help heal our nation after an election that seemed to divide us more than ever.  A piece written by New York Times columnist David Brooks in the heat of this election, “One Neighborhood at a Time,” offers an approach to healing the deep divisions in our country.  He wrote, “The nation may be too large. The individual is too small. The community is the right level.”  

That struck me as very good advice.  As I said in my address this year, communities are the building blocks of our society. They are the places where we work, where our children go to school, where we gather with friends and neighbors in churches, libraries, and parks.  In a strong community, we can depend on each other.  And while academic medicine is not immune to the powerful forces transforming society, every time I visit a medical school or teaching hospital, I see evidence of academic medicine tending to social repair and strengthening our communities. Day after day, our institutions rise above the noise of governmental budget fights, the paralysis of partisan gridlock, and the corrosive effects of prejudice.  

At Learn Serve Lead, I heard many examples of how medical schools and teaching hospitals are transcending those divisions to tackle tough problems and build real, vibrant communities centered on our institutions.  On Saturday, Dr. Mona Hanna-Attisha, MD, MPH, FAAP, director of the Pediatric Public Health Initiative, Michigan State University College of Human Medicine and Hurley Children’s Hospital, joined us to discuss the contaminated water crisis in Flint, Mich., and the role of academic medicine in confronting environmental injustice. Dr. Hanna-Attisha and her fellow panelists shared their experiences confronting environmental threats to their communities; discussed how societal factors, such as racism, affect community care; and suggested ways in which academic medical centers can assess their curricula to ensure that the next generation of physicians is being trained to recognize and mitigate environmental risks.  It was an insightful session about how we can all follow the lead of Michigan State University College of Human Medicine—which received this year’s Spencer Foreman Award for Outstanding Community Service—by committing deeply to our communities so that we are prepared to recognize and respond in moments of crisis. 

From Dr. Hanna-Attisha’s panel on the Flint water crisis, to a session on Native communities and genetic research, to multiple speakers who discussed how we can address the social determinants of health, I heard many examples this week of how institutions around the country are supporting and healing our communities.  

But academic medicine is subject to the same forces of change that affect our society—the pressures that lead to disengagement and social isolation. Every year, Learn Serve Lead provides us with an opportunity to take stock of how we are caring for our own community of academic medicine. Two years ago, at our annual meeting in Chicago, I spoke about the crisis of burnout, depression, and suicide in health care. There is no easy fix for this problem. But over the last several years, I have seen more and more of you working to strengthen the communities inside the walls of your institutions, even as you support the communities outside them.  The AAMC is committed to working with you to build cultures of wellness for our learners and colleagues. We cannot afford to let our own suffer in isolation.  

More than ever, we need to be a community for one another.  And over the last five days, I saw the potential that we have when we come together to share ideas, challenges, and inspiration for our future.  This year’s annual meeting was a vivid reminder of why so many of us chose academic medicine as a career—to improve the health of patients and communities and to make a difference in the lives of learners.  With so many first-time attendees at this year’s annual meeting, it was also a reminder of the importance of building a unified academic medicine that is inclusive and expansive and has a new generation of leaders who will support the health of our communities.  I am leaving this year’s meeting inspired and hopeful about the ways in which academic medicine is strengthening community bonds with learners, with colleagues, with patients, and most of all with the people living just beyond our doorsteps.