AAMC Council of Academic Societies Spring Meeting
Savannah, Georgia, March 23-26, 2000

Richard B. Marchase, Ph.D.
Professor and Chairman of Cell Biology
University of Alabama at Birmingham
More than 100 Council of Academic Society representatives attended the CAS Spring
Meeting.  The opening plenary session focused on "Medical Errors, Accountability
and Professionalism," with the keynote address being presented by Martin J. Hatlie,
J.D., partner, Partnership for Patient Safety, and founding Executive Director, National
Patient Safety Foundation.  He stressed three major challenges to reducing health
care risks: changing the external environment so that it fosters a new understanding
of accountability; improving the internal environment so that service delivery systems
are highly reliable; and finding ways to more effectively manage information,
especially transmitting information about quality of care.  He concluded that progress
would only be made by aligning the delivery system core values, adopting a common
language based on a robust knowledge base, providing education to all members of
the healthcare team, developing a systemic partnership that facilitates "Reaching
through the invisible walls" that exist within our institutions, and providing external
incentives rather than punishments.  Many issues remain unresolved including the
"Blame and punishment" attitude of some institutions and state licensing bodies.  A
panel of commentators added to the discussion.

Heading a plenary session entitled, "The Knowledge Revolution,"   Leroy Hood, M.D.,
Ph.D., Director, Institute for Systems Biology, and C. Thomas Caskey, M.D., President,
Merck  Genome Research Institute, and  Senior Vice President,  Basic  Research,   
Merck  Research  Laboratories, made detailed presentations on efforts to  utilize the
data resulting from  the Human Genome project to identify  the genetic causes of
disease and to develop therapeutic approaches to those diseases.  Dr. Hood
described exciting, high-speed, high-throughput, analytical tools and technologies
being developed to exploit the vast reserve of information emanating from the human
genome and identification of gene functions at the molecular level.  The impact of this
revolution in knowledge will affect every segment of medicine and alter the
physician-patient relationship in ways that are difficult to fully predict.  Alan
Guttmacher, M.D., Senior Advisory to the Director for Clinical Affairs, National Human
Genome Research Institute, detailed some of the changes that will take place in
clinical practice.  Genetic conditions are common enough that most genetics-related
care will be supplied by primary care givers, with occasional involvement of medical
geneticists, genetic counselors, and other specialists.  Some of the changes in health
care will come through: identifying individual genetic predisposition(s); the
maturation of pharmacogenetics; population-based screening for certain disorders;
and a fundamental understanding of the etiology of many diseases, leading to new
approaches even to non-genetic diseases.  These changes raise a number of difficult
social issues.  To prepare health professionals for the genetics knowledge
revolution, students must learn to "think genetically."  In addition to realizing when
genetic factors play a role and being able to explain genetic concepts, practitioners
will need to deal with "risk" and genetic predisposition, to realize personal and
societal impacts of genetic information, to protect genetic privacy, and to use
genetics to individualize patient care and to preserve health.   The session concluded
with a discussion of ways to prepare society at large for the "new genetics," a task
that will involve a level of public education and understanding not successfully
undertaken in recent memory.  Clearly, this is a challenge that our departments must
be ready to help meet.  

Other sessions dealt with "Meeting the Evolving Ethical, Legal, and Practice Demands
of Patients" and "Defining and Evaluating Competency".  An evening banquet
featured a presentation by George Lundberg, M.D., Editor-in-Chief, Medscape.  Dr.
Lundberg presented his vision of how the Internet will affect medical practice and
biomedical research in the future.

At the CAS Business Meeting a new Task Force on Chairs was formed to draft a
proposal for a broad AAMC task force on issues related to chair development.  Dr.
Jordan Cohen, President of the AAMC, presented a detailed report on AAMC
activities.  He identified a number of "faculty front burner" issues, including privacy,
patient safety, human subjects research, intellectual property, time and rewards for
teaching and institutional solvency.  He also stressed four areas of growing concern:
"e-everything," specifically the impact of the information technology revolution on
education, research and patient care: diversity among physicians, scientists, faculty,
and students; the impact of Medicare reform on medical education; and the impact
unionization may have on the relationship between residents and faculty.