university medicine – endangered species?
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University Medicine – Endangered Species?
Kari Raivio, University of Helsinki&
Ilkka Välimäki, University of Turku
Two Milestones in Medicine
High Middle Ages: ArtArt of Medicine => Western Medical ScienceScience 21st Century: Advanced Medical Research and University Health Care => Financial CrisisCrisis in Health Care
I High Middle Ages
Arabic medicineUniversityUniversity medicineBiology in medicinePatientsObsterics and Surgery
Church MedicineLicensing of Medical Practice
Salerno School - 1st Medical University
teaching of Latin, Greek, Jewish , Arabic medical and surgical knowledgeCollegium of Masters of Medicinemedical text booksgranted medical degree
=> Model of early university medical schools
Medieval university medicine
was accompanied by university hospitalbut
was science of academic scholarsand
influenced very little care of ordinary people
II University Medicine in 21st century
cellular pathology pax antibiotica clinical chemistry human genetics biomedical engineering breakthroughs
University schools and hospitals have old traditions ’medieval’ autonomy and mythos corporative (academic scholars!) expensive maintenance but no
more unlimited resources training of medical/paramedical
students research and development
Academic Health Centres economical burden offer high quality health care but at
excessive prize? research not necessarily
understandable by non-university people, politiicians
are AHC’s financially viable???
Public and Private Expenditure on Health USD in 2002 OECD Factbook 2005
Reasons for University Health Care Crisis costs of drugs and
hospital supplies costs of labour costs of high tech ’very sick’ patients problems in
insurance and social security
inefficient economy bad management inability to
constrain expenditures, also by legislation (e.g. BBA in the US in 1997)
etc…
Remedies for UM Crisis? optimal annual negotiations between
university, hospital and communities division/combination of academic and
hospital leadership campaign to revitalise and modernize
academic medicine international discussion and planning
Role of AMSEforum for long-term discussion
and planning of Medical University
teaching goals application of research
inventions modes of health care management
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