Jeff Balser, M.D., Ph.D.
Vice Chancellor for Health AffairsThis marks my first edition of Vanderbilt Medicine as vice chancellor for Health Affairs. It seems fitting (and only a little ironic) that in an issue devoted to the looming shortage of health care providers, the first thing I speak of is the retirement of one of the greatest physician leaders that academic medicine has ever produced. On June 1, Harry Jacobson, M.D., stepped down from a post he held for 12 years – years that reflected his energy, his breadth of vision and his extraordinary capacity to attract the finest scientists, clinicians and educators to invest their careers and their futures at Vanderbilt. It was a dozen years notable for the amazing growth and remarkable achievements.
While the accomplishments of the last decade have been transformative at Vanderbilt and elsewhere, the challenges facing medicine have grown even faster, and are now unprecedented in scale and scope. Care is too costly. Access is inequitable and far too limited. And our public health statistics in many areas are no better than those of Third World countries. The impending crisis is exacerbated by rapidly increasing demand for health care amidst a declining supply of physicians, nurses and other health care providers.
It is apparent that medicine and the way we practice must change. In this issue of Vanderbilt Medicine we explore one of the many issues that confronts health care. We all know the statistics. By 2025 the shortage of physicians could top one quarter of a million – that is if we continue to practice medicine the way we always have. Beyond a call for change, we hope this issue will paint a picture of real reform, illustrating how we are beginning to change the way medicine is practiced through a handful of current initiatives at Vanderbilt – making the entire health care team far more productive, while dramatically cutting the cost of care and taking a quantum leap in improving quality.
Transformative change requires us all to re-imagine the way we practice. We need to build different care teams using the skills and abilities of a new and enlarged group of professionals from nurses to pharmacists to health coaches. We must learn how to both train and practice in teams – not as disconnected individuals in distinct professional silos. With world-class schools of medicine and nursing both engaged and committed to innovation, Vanderbilt has an exceptional opportunity to explore new models, and to lead national efforts aimed at re-conceptualizing the health care workforce.
There is no doubt that the expanded use of information technology will extend our reach, our ability to work as teams, and our quality as caregivers; in this arena Vanderbilt has broad, unparalleled capabilities and a longstanding tradition of leadership. We will need exceptional information tools to allow us to see, monitor and guide the care of many more patients, as we train more doctors, more nurses, and a wide array of health care professionals to effectively use these productivity and quality tools.
If we remain open-minded and innovative in seeking creative answers to the provider shortage, we have the potential to discover lasting solutions that can address even broader challenges in health care – and in doing so re-shape the future of medicine, here and across the globe.