The Principles That Guide Academic Medicine

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Darrell G. Kirch, MD, AAMC President and CEO

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. But as the leading voice for America’s medical schools and teaching hospitals, the AAMC will continue to interact with our nation’s elected officials on this issue, as well as the wide range of policy issues that affect our missions of research, education, health care, and community engagement.  

In the midst of this uncertainty, we at the AAMC have discussed at length the principles and values that guide us—the core beliefs that we have held close during challenging times in the past and that will help us navigate the current health care landscape. The result of those conversations is The Work Ahead for Academic Medicine: Our Guiding Principles, a new document that outlines the foundational principles that guide our work on behalf of America’s medical schools and teaching hospitals. These guiding principles inform our advocacy activities, as well as every decision we make to advance our clinical, scientific, and educational work. They are based on our broad commitments to advancing a health care system that provides high-quality, safe, equitable, and cost-effective care for all; educating a well-trained, culturally competent, and diverse health and biomedical workforce; and discovering new medical knowledge, therapies, technologies, and delivery science to prevent disease, alleviate suffering, and improve quality of life. Under each of these broadly stated commitments, the document describes the specific principles that help us advance each goal.  

Each of these principles serves our overarching mission to improve the health of all. With that vision at their core, these values guide our work on behalf of America’s medical schools and teaching hospitals as they work to create a health care system that is better for patients, communities, and the nation. For example, to advance a health care system that provides high-quality care for all, we continue to work for improved health insurance coverage for all patients. To avoid uncertainty and instability in patients’ access to care, we have urged Congress not to repeal the ACA without simultaneously enacting legislation that maintains or improves current coverage levels. Repealing the ACA without a replacement has the potential to cause patients with complex conditions to forego or delay necessary medical care and could harm the ability of teaching hospitals and their associated physicians to provide complex, coordinated care to the nation’s most vulnerable patients. At the same time, we recognize that the current system has had its share of problems, from premium increases, to declining numbers of insurers in the exchanges, to narrow insurance networks that impede access. Any new changes must address these flaws as well. Because insurance coverage has been shown to lead to better health, we will be steadfast in our advocacy for meaningful, affordable health coverage for all.  

Likewise, our values inform our advocacy to allow medical students and residents with Deferred Action for Childhood Arrivals (DACA) status the ability to pursue and complete their education and training. The participation of individuals with DACA status in the health care workforce benefits all U.S. patients by contributing to a diverse and culturally responsive physician workforce. The AAMC has urged President-Elect Trump not to revoke the current DACA executive action until Congress approves a permanent pathway to legal immigration status for students and residents with DACA status, and we have supported legislative efforts on this front.  

In these and other areas, the AAMC will continue to advocate for policies that support and improve the health of our nation. Specifically, we will continue to advocate for sustained, predictable growth for biomedical research funding, and we have taken a strong stance against political interference in establishing research priorities. We will also continue in our efforts to ease the burden on researchers by pushing for reduced and streamlined medical research regulations, such as the AAMC-backed provisions to provide administrative relief for researchers that were included in the 21st Century Cures Act when it passed in December. Likewise, the AAMC will continue to shape medical education and the future of our physician workforce by advocating for federal policies that help ensure an affordable education for students from all backgrounds, and we will continue to oppose political attempts to legislate the content of medical education curricula. And from improving veterans’ health, to preserving access to benefits for seniors who rely on Medicare, to finding solutions to the opioid crisis, the AAMC is committed to solving the problems that keep American citizens from achieving optimal health.  

Our principles are our beacons. They have guided the work of the AAMC and our members for many years, and they will continue to guide us as we engage in the new political landscape and work to ensure that academic medicine’s priorities are heard and understood. We will continue to advocate on behalf of the patients we are privileged to serve. But we cannot do it alone—we need all of academic medicine to join us if we are to succeed. If you are interested in advocating with us, I encourage you to join AAMCAction, a digital community of more than 180,000 medical students, residents, faculty, and others in the academic medicine community who advocate directly on these issues. As lawmakers consider a number of issues that affect medical schools and teaching hospitals, we will hold steadfast to our guiding principles. They have led us through uncertain times before, and they will do so again.