Governance of academic medicine should be with public trustees
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《英国医生杂志》
EDITOR—Many of the problems arising in academic medicine are due to the divergence of academic goals and the values of society. Academic institutions are not currently governed in a way that fosters a strong and healthy alliance with government and the population at large, and there is a failure to support satisfactorily the public interest against vested and other competing interests.1
We suggest that a good first step is to turn over the governance of academic medicine to public trustees with protected authority. Public trustees must ensure that the three familiar goals of research, teaching, and patient care are supplemented by the unsung fourth goal of community service. Moreover, trustees have the right to insist that most of the research and teaching programmes in academic medicine be placed in the context of the health needs of the entire population.
It is also time to reform the governance of medical schools. We suggest that it fosters tunnel vision for the dean when the executive committee of the medical school is composed primarily of department chairpeople whose main responsibility is the welfare of individual departments, not the mission of the school as a whole. We advocate instead an executive committee comprising senior faculty and public representatives, while excluding department heads.
If academic medicine exists to promote the public interest, is it not time to grant patients and the public at large a controlling interest in setting priorities and overseeing operations?
Mary G Baker, president, European Parkinson's Disease Association
Woking, Surrey GU22 0SH
B S Singhal, professor
Department of Neurology, Bombay Hospital Institute of Medical Sciences, Mumbai 400 020, India
Matthew Menken, chairman
World Federation of Neurology Research Group on Medical Education, 54 Rollingmead Road, Princeton, NJ 08540, USA MMenken712@aol.com
Competing interests: None declared.
References
Lewis IJ, Sheps CG. The sick citadel: the American academic medical center and the public interest. Cambridge, MA: Oelgeschlager, Gunn and Hain, 1983: 241.
We suggest that a good first step is to turn over the governance of academic medicine to public trustees with protected authority. Public trustees must ensure that the three familiar goals of research, teaching, and patient care are supplemented by the unsung fourth goal of community service. Moreover, trustees have the right to insist that most of the research and teaching programmes in academic medicine be placed in the context of the health needs of the entire population.
It is also time to reform the governance of medical schools. We suggest that it fosters tunnel vision for the dean when the executive committee of the medical school is composed primarily of department chairpeople whose main responsibility is the welfare of individual departments, not the mission of the school as a whole. We advocate instead an executive committee comprising senior faculty and public representatives, while excluding department heads.
If academic medicine exists to promote the public interest, is it not time to grant patients and the public at large a controlling interest in setting priorities and overseeing operations?
Mary G Baker, president, European Parkinson's Disease Association
Woking, Surrey GU22 0SH
B S Singhal, professor
Department of Neurology, Bombay Hospital Institute of Medical Sciences, Mumbai 400 020, India
Matthew Menken, chairman
World Federation of Neurology Research Group on Medical Education, 54 Rollingmead Road, Princeton, NJ 08540, USA MMenken712@aol.com
Competing interests: None declared.
References
Lewis IJ, Sheps CG. The sick citadel: the American academic medical center and the public interest. Cambridge, MA: Oelgeschlager, Gunn and Hain, 1983: 241.