The news was bad on two fronts last week for America's teaching hospitals.
First, a report by the New York-based Commonwealth Fund found that some of the nation's medical schools and their affiliated teaching hospitals are falling short of their key mission-training America's future doctors.
On the same day that the study was issued, the American Hospital Association released a report indicating that public and private payers are becoming less willing to support the mission of teaching hospitals. The AHA's study showed that the total reduction in Medicare funding for teaching hospitals has reached $76.7 billion since initiation of the Balanced Budget Act of 1997.
"This loss of federal support comes at a particularly painful time for our teaching hospitals as they grapple with a struggling economy, nursing shortages and intense pressure to ensure our readiness for the possibility of future terrorist attacks," said Jordan Cohen, M.D., president of the Association of American Medical Colleges.
The Commonwealth Fund's report said several factors are preventing medical schools and affiliated academic health centers from keeping pace with today's medical challenges-including a focus on short hospital stays, high clinical workloads and a growing emphasis on ambulatory services.
The clinical environment within academic health centers is perceived as "unreceptive" to medical education because of issues such as a significant decrease in Medicare patients' average length of stay.
What's more, academic health centers rarely provide reliable data to help measure the centers' effectiveness.
"The fundamental rationale for the existence of academic health centers is the education of the nation's healthcare workforce, yet we have no way of measuring how well they are performing their task," said David Blumenthal, M.D., executive director of the task force that produced the Commonwealth report and director of the Institute for Health Policy at Massachusetts General Hospital/Partners HealthCare.