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Message from Dean Richardson: Staking out the middle ground

Dean RichardsonDear School of Medicine Community:

Graduation season has arrived and as our learners move into their chosen health sciences professions, I am reminded again how grateful I am for the passion, dedication and commitment of our students, faculty, staff, alumni and many others in the School of Medicine community. These milestone moments – the culmination of so many years of hard work – bring new beginnings and new opportunities for all of us. There’s no better time to think about where we have been and where we are going.

The prevailing trends in academic medicine, and in society as a whole it seems, are being influenced by fundamental and potentially lasting shifts in our national and state economies and the resulting funding models. OHSU and others in academic medicine are taking important steps to adapt to ensure we continue to thrive in this 21st century reality. However, the uncertainty associated with the emerging reality can be unsettling. And in uncertain times, there is a natural tendency to seek black and white answers or to stake out clearly delineated territory. The current political divide is an example of this polemic. We seem unable to find compromise and instead focus on short term outcomes and positioning our side to “win.”

The discussion around our nation’s primary care access challenge is another example of this tendency. The national debate is tinged by black and white thinking. I’ve seen the consequences of this play out in many different ways. In our own community, we sometimes see this debate focused unconstructively on the merits of primary versus specialty care or the value of one type of health care professional versus another. As the discussion focuses on taking “sides,” this either/or dichotomy obscures the big picture: both are absolutely critical and balance is what’s needed.

Now more than ever, during this period of intense and rapid change and pressured resources, our goal must be mission and program balance. Society depends on academic medicine – on us – to deliver a wide range of “public goods” and our focus on providing these outcomes in a balanced manner must remain at the forefront of all our discussions and decisions. OHSU has proven itself to be uniquely positioned to do so. Protecting this unique ability will be one of my own highest priorities in the coming years.

Because primary and specialty care are both essential to an effective health care system, balancing access to these services will be a key challenge as we shape new team-based delivery models that will underpin the future health care system. The success of these new delivery models will depend on an integrated and balanced approach to education across all health care professions. Another example comes from research: a balanced portfolio across the full spectrum of research, basic all the way to evidence-based, is essential to ensuring continued accumulation of breakthroughs and discoveries that ultimately improve human life and well-being.

Mission balance is not a new topic. I wrote about it last July when we learned about the study from the Annals of Internal Medicine ranking us #11 among all U.S. medical schools for training the physicians most needed by society. The study also found that the level of support from the National Institutes of Health for research correlated inversely with output of primary care physicians and that schools with small "research portfolios" were more likely to meet the social mission of training these physicians. Unlike most medical schools, the study showed we were doing both – a large research portfolio (and the associated biomedical achievements) as well as excellence in primary care education.

I’m proud that we are already achieving good balance across our missions but it is something we must continue focusing on – the challenge and opportunities – as we define our own future. I look forward to – and will rely on – your input. I also look forward to celebrating commencement and hooding with our newest alumni and all of you on June 6 at 9:00 am at the Arlene Schnitzer Concert Hall in Portland.

Thank you for everything you do for OHSU and Oregon.

Best regards,


Mark Richardson, MD, MBA


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