What do Americans know about academic medical centers? Not much, according to a recent survey.
Last year the Association of American Medical Colleges retained William McInturff of Washington-based Public Opinion Strategies to find out what Americans want from their academic healthcare providers.
McInturff's findings, which he presented at the AAMC's annual meeting last November, indicate many Americans don't connect academic medical centers to quality healthcare because they don't understand what such institutions do.
"Americans believe that this country's medical education, care and research are among the finest in the world," McInturff's report said. "They do not, however, connect the terms `academic medical center' or `academic medicine' with these highly valued outcomes."
That's because the term "academic medical center" is not easily understood, said Susan Neely, AAMC vice president of communications. The public doesn't know that academic medical centers and teaching hospitals are one and the same.
Based on the new data, the AAMC this spring will launch a communications effort to increase public awareness and understanding of what its members do. The AAMC's membership includes the nation's 125 accredited medical schools and some 400 teaching hospitals.
Public Opinion Strategies' report defines academic medical centers as "medical schools and teaching hospitals that link together research, medical education training and patient care."
The research firm's two-part approach involved focus groups in cities around the country where academic medical centers are prominent, followed by a national survey of 900 respondents. About one-third of the survey respondents lived in areas without such institutions.
Not only don't Americans understand teaching hospitals, medical schools or academic medicine, they also have misconceptions about them.
For example, only 39% thought academic medical centers were not-for-profit, and those respondents came from markets with AAMC member hospitals and medical schools. In actuality, few of the nation's teaching hospitals are for-profit and taxable.
"The focus groups had a great anxiety about the intrusion of business concerns into their healthcare," Neely said. "Just the words `for-profit' were negative."
Beyond tax status, the public doesn't realize that such institutions provide more than education and research-namely, quality care.
"The No. 1 myth you have to dispel is that people can't call up and make an appointment at your hospital," said Susan Phillips, vice president of government and public affairs at University of Chicago Hospitals. "People believe academic medical centers are just for experimental therapies, and that's just not true."
Americans may be scratching their heads over what academic medical centers do, but they do view such institutions favorably. Some 67% of respondents had an overall favorable opinion of teaching hospitals (See graphic). And 59% want to be treated at such facilities for complicated medical conditions.
The AAMC believes the next step is to put such positive feedback to work. "We need academic medical centers to use this information in their own communications and marketing departments," Neely said. "Business terms like `gatekeeper' and `cost cutting' are what purchasers want to hear, but they are exactly what consumers don't want to hear."
The spread of managed care and its emphasis on lower costs threaten revenue streams of teaching hospitals, whose costs can be as much as 30% higher than community hospitals', according to the Prospective Payment Assessment Commission.
That's because teaching hospitals not only support patient care, they also have the added costs of medical education and research and are more dependent on Uncle Sam's federal subsidies.
The public seems to recognize the benefits of moving federal dollars to teaching hospitals. Based on a hypothetical example, respondents supported a 2% tax on health insurance premiums if the dollars were spent on medical care (61% favored), medical research (63%) and medical education (56%).
Sixty percent of those surveyed thought HMOs and insurance companies were cutting back on what they would pay for medical procedures, thus hurting teaching hospitals' research budgets.
The AAMC hopes its communications plan, which is still under development, will make the public more aware of the danger of payer cutbacks.
"There's a passivity that makes us nervous," Neely said. "The public has come to expect the best, and they take it for granted that it will always be there. We've got to make the link a little more strongly that these outcomes that they value, like well-trained doctors and research, could be in jeopardy."