university medicine – endangered species? kari raivio, university of helsinki & ilkka...

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 medicine

UniversityUniversity medicine

Biology in medicine

Patients

Obsterics and Surgery

Church Medicine

Licensing of Medical Practice

Salerno School - 1st Medical University

teaching of Latin, Greek, Jewish , Arabic medical and surgical knowledge

Collegium of Masters of Medicine

medical text books

granted medical degree

=> Model of early university medical schools

Medieval university medicine

was accompanied by university hospital

but

was science of academic scholars

and

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 AMSE

forum for long-term discussion and planning of Medical University

teaching goals application of research

inventions modes of health care management