Hospital executive says academic medical centers contribute breakthroughs

Academic medical centers have produced breakthroughs in medicine but could be threatened by the health care reform law, Dr. Herbert Pardes, president and chief exeuctive of New York-Presbyterian Hospital, said at a March 31 Newsmaker.

The centers are the “jewels in the crown of American medicine,” he said, referring to a quote by the late Sen. Daniel Patrick Moynihan. They “reach profoundly into the lives of millions of people, with lifesaving treatments.”

Academic medical centers “hold the promise of tomorrow’s medical advances,” Pardes said. “Often, academic centers pierce frontiers and try new treatments for the first time.”

Advances achieved at centers include the first transplants of liver, heart and bone marrow. A 2004 study by the Institute of Medicine found that 87 percent of academic medical centers have trauma centers, compared to 30 percent of non-teaching hospitals; 88 percent have transplant services compared to 5 percent of non-teaching hospitals; and 5 percent of open heart surgery compared to 27 percent at other facilities.

Pardes said that health reform could adversely affect the centers through value-based purchasing, penalties for hospital-acquired conditions and re-admissions, the adoption of quality indicators on accidental punctures and lacerations and across-the-board cost reductions.

“Without appropriate risk adjustments, value-based purchasing, as enacted, could wind up rewarding hospitals in more affluent areas and punishing excellent hospitals in challenged communities, where many academic medical centers are located,” Pardes said.

In addition, centers that have a high ratio of medical procedures “involving sharp objects or surgical procedures will have a larger number of accidental punctures or lacerations,” and as a result may “suffer potential financial penalties and lose patients who get a distorted view of quality.”

Pardes has served as dean of Columbia University’s medical school, director of the National Institute of Mental Health, president of the American Psychiatric Association and assistant U.S. surgeon general from 1978-84.

“In this challenging period, academic medical centers can help the nation meet the combined health reform goals of increasing access, improving quality and reducing cost,” Pardes said. They are “vital to all Americans and we must do all we can to protect them.”