CAS Programs at the AAMC Annual Meeting

November 3-7, 2001,  Washington, DC
Joanne Ruhland, Assistant Dean for Government Relations, Wake Forest University
School of Medicine, and P. Pearl O'Rourke, M.D., Director, Human Research Affairs,
Partners HealthCare Systems, provided attendees with an overview of the legislative
advocacy process. They also provided valuable lessons, based on their own
experience, of how to frame issues and communicate advocacy messages effectively. A
lively discussion with the audience focused on the role of faculty vis-à-vis their
government relation's office.

Council of Academic Societies/Council of Deans/Council of Teaching
Hospitals and Health Systems Joint Plenary

The Cost of Compliance: Dollars, Time and Faculty Morale

Russel E. Kaufman, M.D., Associate Vice Chancellor for Academic Affairs, Duke
University School of Medicine, addressed the compliance issue as it relates to
research. Dr. Kaufman discussed the current research-funding dilemma ? increased
research volume, reduced clinical revenues, limited indirect cost recovery, and
skyrocketing compliance costs. Compliance with various federal dictates has become
increasingly more complex and the penalties for non-compliance can be severe. A
variety of internal factors make compliance difficult in an academic setting. Institutions
have difficulty understanding their compliance costs and sizing their compliance
programs. Dr. Kaufman detailed human subject compliance costs at Duke University as
well as the costs of federal sanctions. He also discussed the organization of
compliance responsibilities on the Durham campus. Lastly, he discussed a number of
ways that institutions and federal agencies can help faculty be most compliance
sensitive. (Slide set available on the CAS Private Web Page.)

Mark E. Erath, CPA, Partner, Healthcare Consulting Practice, PricewaterhouseCoopers,
LLP, discussed the compliance issue as it relates to health care. He specifically
discussed a recent study conducted for the American Hospital Association. The study
showed that physicians, nurses and other hospital staff on average spend at least 30
minutes on paperwork for every hour of patient care provided to a typical Medicare
patient. In the emergency department, every hour of patient care generates an hour of
paperwork - including complying with the vast array of federal, state and local health
regulations. The study illustrates a typical episode of care - an elderly woman who falls
and fractures her hip - and the patient care and paperwork resulting throughout her
course of care. (Slide set attached.)

Haile T. Debas, M.D., Vice Chancellor for Medical Affairs, Dean, School of Medicine,
University of California, San Francisco and Mark Laret, CEO of UCSF Health Care,
commented on the presentations by Dr. Kaufman and Mr. Erath.

Council of Academic Societies/Council of Deans/Council of Teaching
Hospitals and Health Systems/ Group on Information Resources Joint

IT: Is Your Organization Peering into a Black Hole or Seeing the Light?

Mr. Jeff Otten, President, Brigham and Women's Hospital, discussed three areas related
to information technology and health care costs: the current environment, what to
expect from IT, and some of the IT solutions at Partners/Brigham and Womens's
Hospital. The current environment affecting academic medicine includes rising patient
expectations, demographics, technological developments, aggressive pursuit of
money, disintegration of home health, rehab, and skilled nursing, and increased
accountability. He discussed how IT could help by replacing managed care with medical
management through the use of automated clinic guidelines, pharmaceutical
management, outcome measures, public reporting and accountability for cost and
quality. IT can also help improve communication with patients. The growing field of
bioinformatics will play an important role in understanding and treating disease. IT is
being used to improve the billing process and operations by reducing errors. Mr. Otten
presented a list of expectations of the chief information officer to understand the
complexity of their role and of IT's place in the health system.

Carl Berger, Professor and Director of Advanced Academic Technologies, University of
Michigan, discussed the future impact of technology on education. Professor Berger
shared the results of his survey of University of Michigan faculty and student use of
technology to improve learning. The largest responding group was in medicine. It was
encouraging that most participants report some expertise in technology use - over 96
percent use tools every day. However, he also learned that lack of time and support to
use technology were the greatest barriers and the telephone, workshop and on-line
resources consistently received the lowest ratings as pathways for assistance. Overall
methods of choice were to learn from colleagues and friends. Some concerns
expressed were the time it takes to learn and use technology, reliability of technology,
and lack of necessary support. Dr. Berger's report and survey tool are available on his
web site at
http://sitemaker.umich.edu/cberger. He also demonstrated how Michigan is
using the visible human project and technology to improve learning.

Monday, November 5

Council of Academic Societies-Women in Medicine Breakfast

Tabletop discussions were held on the following topics:

Faculty under siege: supporting career development

Improving mentoring in academic medicine

Women faculty organizations: what's working?

Enhancing the environment for gays and lesbians in medical education

Encouraging students toward an academic career

Interdisciplinary women's health education curriculum development and                            

Monday, November 5

See the attached minutes and attachments.

Monday, November 5

Rebecca S. Dresser, J.D., Professor of Law and Medicine, Washington University School
of Law, Washington University School of Medicine, discussed the growing agenda of
patient advocates and how it is changing research policy, practice, and ethics.
Research advocacy is becoming increasingly commonplace - from celebrities such as
Michael J. Fox and Christopher Reeve, whose medical conditions have led them to
promote research for the appropriate cure, to community leaders representing a
specific population, to clinicians or researchers, whose work brings them in contact
with a certain disease. Today's advocates have become vocal partners in the health
research enterprise, as they lobby for research funding, encourage study participation
and help evaluate studies. Professor Dresser stressed that advocates representing an
array of patient groups have played a major role in helping make health research more
responsive to the people it is designed to serve.

Professor Dresser said that while research advocacy can help make research more
ethical, it raises ethical issues of its own. Professor Dresser cautioned against
premature attempts at novel interventions in humans and the blurring of boundaries
between research and treatment. She cites the devastating effect on patients and their
families when potential outcomes of research are exaggerated and risks are
downplayed. To reduce public confusion about the differences between experimental
interventions and established therapies, advocates should promote straightforward
information about clinical trials and acknowledge the limits of research. To minimize
competition and questionable decision-making in research funding, Professor Dresser
said advocates could expand their view to encompass the best interests of numerous
patient groups and broader societal concerns, including greater access to standard
health care. (Presentation outline attached.)

Myrl Weinberg, President, National Health Council and Alastair J.J. Wood, M.D.,
Assistant Vice Chancellor for Research, Prof. of Medicine, Prof. of Pharmacology,
Vanderbilt University School of Medicine, led a lively discussion related to Professor
Dresser's presentation.
CAS Draft Business Meeting Summary Minutes

November 5, 2001

Washington, DC
I. Call to Order
The Council of Academic Societies (CAS) Business Meeting was called to order by Dr.
Terry Cooper, Chair of the CAS, at 12:15 p.m.

II. Consideration of Minutes
On motion, seconded and carried, the minutes of the March 23, 2001, CAS Business
Meeting were approved.

III. Chairs Task Force Report
Dr. Lloyd Michener reported that the Chairs Objectives Project Drafting Panel is
scheduled to meet from November 30-December 2 to begin work on a draft of the
document. This document, a description of the attributes of a successful chair, will be
published as a stand-alone monograph and will be incorporated into the three-volume
manual being developed on good practices in the development of the successful
department chair, a project headed by Dr. Julien Biebuyck, Scholar-in-Residence at
the AAMC. Dr. Michener noted that there are several other initiatives underway at the
AAMC which will prove very useful to department chairs. These include the Faculty
Administrative Management On-line User System (FAMOUS) and the AAMC/UHC
initiative to develop benchmark data for department chairs. Dr. Michener welcomed
comments and input from the CAS membership on the project.

IV. AAMC President’s Report
Dr. Jordan Cohen opened his report to the CAS by identifying the shortcomings of the
new AMCAS 2002 web-based application service. He announced that Mr. Joseph
Keyes, the Association’s General Counsel, now holds executive level responsibility
for AMCAS. Additionally, a team from IBM Global Solutions has been engaged to assist
with evaluating and reengineering the system. Dr. Cohen stressed that AAMC is
committed to the concept of AMCAS and will make restoring confidence in the system
a top priority.

Dr. Cohen announced that the AAMC had embarked upon a new bioterrorism initiative
entitled, "First Contact, First Response." The plan will ensure that the medical
community is prepared to respond to terrorist attacks and to address the educational
needs of medical students, residents and practicing physicians. The AAMC will
convene an expert panel to provide guidance to medical schools on adding
curriculum content relevant to biological agents and radiation and chemical exposure.
The AAMC will also continue to build on a cooperative agreement with the CDC to
improve existing partnerships between public health and medicine.

In conclusion, Dr. Cohen reported on the AAMC’s initiatives to address the protection
of human subjects involved in research. The Association for the Accreditation of
Human Research Protection Programs (AAHRPP) has been formed under the direction
of the newly named Executive Director, Marjorie Speers, Ph.D. Dr. Cohen announced
that the AAMC Task Force on Financial Conflicts of Interest will be presenting its final
report on individual conflicts to the AAMC’s Governance in December. Efforts to
address the issue of institutional conflicts have begun.

V. Government Relations Report
Dr. Richard Knapp discussed the changes in the political environment as a result of
the events of September 11. He touched briefly on several key pieces of legislation
effecting the AAMC’s advocacy agenda including the American Hospital Preservation
Act (H.R. 1556/S.839) and the Medicare Education and Regulatory Fairness Act of 2001
(H.R. 868/S.452). He also commented on a proposed bill – the Patient and Physician
Safety and Protection Act, which seeks to place a limit on resident work hours. AAMC
opposes this legislation and does not support government involvement or regulation
of the issue. Dr. Knapp outlined the issues pertaining to healthcare of the OIG’s 2002
work plan. In closing, he noted that the proposed appropriations increases for FY2002
are reasonably favorable for the healthcare community. Dr. Knapp’s slide set is

VI. Program Committee Report
Dr. Lynn Eckhert reported on the progress of the CAS Annual Meeting scheduled for
March 14-17 in Santa Fe, NM. She announced several of the confirmed speakers
including a keynote address by Francis Collins, M.D, Ph.D., Director of the National
Human Genome Research Institute. Dr. Eckhert also announced that the dinner
address will be given by Lori Arviso Alvord, M.D., the first Navajo woman surgeon. Mr.
David Hunter of the Hunter Group will also present. Dr. Eckhert requested that the
membership forward any suggestions for the Critical Issue Discussion Groups
scheduled for Friday morning and the "hot topics" session scheduled for Sunday
morning to Mr. Tony Mazzaschi.

VII. Basic Science Leadership Forum Update
Dr. Bill Dantzler reported on the progress of the Basic Science Chairs Leadership
Forum, designed to foster discussion of issues related to the role of basic science
chairs and basic science disciplines. A key activity of the Committee will be to advise
AAMC staff on the programming for a national meeting to address issues of
importance to basic science chairs. The National Forum is scheduled for October 11-
13, 2002, in Philadelphia, PA.

VIII. Membership Committee Report
Dr. Barbara Schuster reported that the CAS membership now stands at an all-time high
of 98 member societies (16 basic science societies, 77 clinical societies, and 5
interdisciplinary societies). The combined (duplicated) membership of the CAS
member societies is over 400,000. Dr. Schuster encouraged members to continue to
suggest additional members.

During the past year, eight new societies were admitted into the CAS.

Academy for Health Services Research and Policy Foundation
American College of Medical Genetics Foundation
American Medical Women’s Association Foundation
Association of Medical School Neuroscience Department Chairs (Pending Tax Status
Association of Medical School Psychologists
Council on Medical Student Education in Pediatrics
Surgical Infection Society
Training Program Directors of the American Academy of Allergy, Asthma & Immunology

IX. Professionalism Task Force Update
Dr. Cooper reported on the Professionalism Roundtable held on March 22, 2001. He
explained that the professional writer who was hired to summarize and synthesize the
discussion was not able to do so. Therefore, Dr. Cooper organized the information into
eight themes that capture the essence of all comments put forth during the
roundtable. Dr. Cooper encouraged the members to review the text and submit
comments and suggestions for revisions.

X. Nominating Committee Report
Dr. Paul McCarthy, chair and nominating committee members: Drs. Terrance Cooper,
Stebbins Chandor, Lynn Epstein, Julian Garvin, Linda Giudice, and David Sklar, put
forth the following slate of candidates:

Chair Elect:
William Dantzler, M.D., Ph.D., American Physiological Society

Administrative Board:
Shelley Bader, Ed.D., Association of Chairs if Departments of Family Medicine
Antonio Scarpa, M.D., Ph.D., Association of Chairs of Departments of Physiology

CAS Representatives to the AAMC Executive Council:
Lynn Eckhert, M.D., Dr.P.H., Association of Teachers of Preventative Medicine
Terrance Cooper, Ph.D., American Society for Microbiology
William Dantzler, M.D., Ph.D., American Physiological Society
Lynn C. Epstein, M.D., Assn. for the Behavioral Science and Medical Education
J. Lloyd Michener, M.D., Association of Departments of Family Medicine
Barbara Schuster, M.D., Association of Program Directors in Internal Medicine

XI. Election of Officers
No Nominations were offered from the floor and the slate of candidates was approved
as presented.

XII. Recognition of the New CAS Chair
Dr. Cooper presented the gavel to the incoming chair, Dr. Lynn Eckhert. Dr. Eckhert
accepted the gavel and thanked Dr. Cooper for his leadership during the past year.

XII. Adjournment
With no further business to discuss, Dr. Eckhert adjourned the meeting at 2:00 p.m