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Changing Landscapes in Academic Medicine: What do we do now????

Changing Landscapes in Academic Medicine: What do we do now????. Barry R. DeYoung, MD Acting Chair/DEO Frederic Stamler Professor of Pathology University of Iowa. Notice of Faculty Disclosure.

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Changing Landscapes in Academic Medicine: What do we do now????

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  1. Changing Landscapes in Academic Medicine: What do we do now???? Barry R. DeYoung, MD Acting Chair/DEO Frederic Stamler Professor of Pathology University of Iowa

  2. Notice of Faculty Disclosure In accordance with ACCME guidelines, any individual in a position to influence and/or control the content of this ASCP CME activity has disclosed all relevant financial relationships within the past 12 months with commercial interests that provide products and/or services related to the content of this CME activity. The individual below has responded that he/she has no relevant financial relationship(s) with commercial interest(s) to disclose: Barry R. DeYoung, MD

  3. Philosophy According to Yoda "Difficult to see. Always in motion is the future."

  4. What we know…… • Volume of tests (specimens) is going to continue to increase • Directly related to aging population as well as increased access to screening procedures such as mammography and colonoscopy • Considered a good thing???? • Reimbursement will be decreasing • Possibly in real terms (radiology); for sure in terms of growth

  5. What we know II ……. • We have obligation to provide our junior faculty/next generation the opportunity to have an academic career in all phases of the tripartite mission • How do we procure the appropriate resources in a world of constricting resources??? • The Chair/DEO conundrum…… • Where to procure resources to meet all demands and maintain balance across missions????

  6. Possible Ways to Enhance/Provide Resources for Academic Development • Surtax/Sequester on/of small percentage of highest salaried individuals • Can lead to a pool of money to be utilized solely for the purpose of junior faculty academic development • Small percentages of salary on various grants • Even though small, and even though very difficult in current funding situation, small amounts add up

  7. Possible Ways to Enhance/Provide Resources for Academic Development II • Credit for services provided • At Cancer Center initiative, have procured funding support for activities related to patient care and research within the CC • Two levels of support • Basic oncology patient care activities • Support of specific research and/or investigative related activities (support of tumor repository) • 8 faculty X 7500 per (60K) • Additional support for faculty involved in Molecular Pathology (10K per faculty) • These funds help defray salary, freeing up other departmental funds for academic development

  8. Possible Ways to Enhance/Provide Resources for Academic Development III • Outreach activities • Many different forms and shapes ranging from consultative AP services to “full shop” • Difficult to compete with large labs for any number of reasons • Many different business models which tend to be institution specific • Depending on agreement with institution, can range from profitable to exceptionally profitable • Projects to remain so, at least short and intermediate term • Especially true for “niche” markets such as Renal, Nerve/Muscle where volumes are increasing and the complexity of the testing makes even technical cuts difficult • Under threat when population reimbursement (capitation) or outpatient DRG’s come into play

  9. University of Iowa Diagnostic Labs (UIDL) • Predominantly AP driven; much activity related to niche markets • Annual growth in billed and collected charges for last decade • Purchases technical services from hospital; professional charges subject to Dean’s tax (6.5%); some payout to faculty involved as incentive • Allows for significant underwriting of faculty development as well as deposits to reserve funds

  10. UIDL Charges and Revenues

  11. Conclusions • Current environment is threat to academic department’s ability to foster appropriate faculty development • Departments must “diversify” as best they can to insure consistent revenue streams • As a “hospital based” practice exist limited ways exist to achieve diversification • Partnering with other stake holders within the institution or enriching outreach activities may have some traction in achieving consistent or increased revenue • Long term, even greater threats on horizon with population based care and outpatient DRG’s • Need to be highly vigilant, creative, and entrepreneurial to meet the challenges successfully

  12. Discussion????

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