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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: Art of Medicine => Western Medical Science
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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: Artof Medicine => Western Medical Science • 21st Century: Advanced Medical Research and University Health Care => Financial Crisis in Health Care
Arabic medicine University medicine Biology in medicine Patients Obsterics and Surgery Church Medicine Licensing of Medical Practice I High Middle Ages
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
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… Reasons for University Health Care Crisis
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