Saturday, November 21, 2015

National Physician of the Year Awards

Each year in March, Castle Connolly, Ltd, a medical company in New York City, presents the Castle Connolly National Physician of the Year Awards. As a member of the advisory board of Castle Connolly, who publishes books and articles on America’s Top Doctors, I am called upon annually to help select two Lifetime Achievement and three Clinical Excellence Awards. Clinical peers and hospitals nominate the candidates.

The candidates are invariably specialists from major academic centers who have pioneered innovations, written hundreds of papers, been national leaders in their specialties, received multiple awards, led or served on national specialty or editorial boards of their discipline.

This year’s candidates

Lifetime Achievement Nominees

• Joseph S. Torg, MD, Temple U. Hospital, Orthopedic Surgery, Sports Medicine

• Hricak Hedvig, MD, Memorial Sloan Kettering, Diagnostic Radiology

• W, Gerald Austen, MD, Massachusetts General Hospital, Chairman, Cardiac Surgery

• Arnold Cohen, MD, Einstein Healthcare Network, Obstetrics and Gynecology

• David Apple, MD, Shepherd Center , Atlanta, Orthopedic Surgery

• Suzanne Oparil, MD, University of Alabama, Cardiovascular Disease

• Richard J. O’Reilly, MD, Memorial Sloan Kettering, Medical Oncology

• Herbert Dardik, MD, Englewood Hospital and Medical Center, Vascular Surgery

• Randall Olsen, MD, University of Utah and John Moran Eye Center, Ophthalmology

• Valentin Foster, MD, Mount Sinai Hospital, Cardiovascular Disease

• James D. Crapo, MD, National Jewish Center, Pulmonary Disease

Clinical Excellence Nominees

• William J. Catalona, MD, Johns Hopkins, Urology

• Fred Telischi, MD, MD, University of Miami, Otolaryncology

• Alice Yu, MD, University of California, Pediatric Hematology-Oncology

• Jeffrey Speigel, MD, Lahey Hospital and Medical Center, Otolaryngology

• Ihor S. Sawczku, MD, Hackensack University Medical Center, Urology

• Victor Navorro, MD, Einstein Healthcare Network, Hepatology

• Ross Zafonte, MD, Spaulding Rehabilitation Center, Physical Medicine and Rehabilitation

• Phillip Stieg, MD, MY-Presbyterian/Weill Medical College, Neurosurgery

• Eva Feldman, MD, University of Michigan Health System, Neurology

• Debra Somers Copit, MD, Einstein Health Network, Diagnostic Radiology

• Mark R. Katlic, MD, Sinai Hospital, Geriatic Medicine

• Kenneth Anderson, MD, Dana Farber, Hematology

• Everett E. Vokes, MD, University of Chicago, Medical Oncology

• Robert Spetzler, MD, University of Pittsburgh, Neurosurgery

• Anthony Atala, MD, Wake Forest Institute, Urology/Regenerative Medicine

• Ricardo L. Carrau, MD, Ohio State University, Otolaryngology/Head and Neck Surgery

• Alberto Esquenazi, MD, Albert Einstein Medical Center, Physical Medicine and Rehabilitation

• Mani Menon, MD, Henry Ford Health System, Urology

A Footnote

Specialists in academic medical centers are the sinews of America’s worldwide reputation for excellence. This event, the Castle Connolly National Physician of the Year Awards, is medicine’s way of celebrating excellence. I consider it Medicine’s Academy Awards.

While we celebrate this event, it is worth noting these specialists and hospitals they represent are under financial stress because of cutbacks in federal funding, reimbursements for specialists, and ObamaCare regulations. With the reduction in federal grants and these other factors, these specialists and hospitals must make up the shortfalls.

How to do this? Victor J. Dzau, MD, president of the Institute of Medicine and an academic himself (NEJM, "Transforming Academic Health Centers for an Uncertain Future," September 12, 2013) has these comments and suggestions.

“ In academia, it is no longer be enough to serve your local and regional communities or to have a cluster of world class specialty centers. It is no longer enough to attract National Institute of Health and other grants. It is no longer enough to have a series of independent specialized fiefdoms connected by a common heating system, a commodious parking lot, and buildings held together by a prestigious academic name. It is no longer enough ‘Publish or perish.’ “

Now, faculty members must “transform or perish.”

Dzau et all cite the following factors as having brought about this new state of academic affairs:

• ObamaCare regulations

• Reductions in Medicare and Medicaid reimbursement

• Driving of health plan enrollees to lower cost providers and into narrow tiered networks of physicians and hospitals

• Ending of government funding for hospitals treating low income patients.

The result is that academic centers are falling 30 to 40 cent short for every federal dollar needed to support their research and educational missions.

How to respond?

Dzau recommends these survival strategies.

• Balance specialized clinic excellence with population health.

• Combine “centers of excellence” with research translating that excellence into training for doctors.

• Become high-performing regional health systems ”spanning the spectrum from community-based and primary care to highly specialized hospital and post-acute care, all linked by effective information systems.

• Increase research yields by translating results so they have an immediate impact on practices and services offering natural economies of scale and fostering innovation and entrepreneurship.

• Offer new ways to engage patients, through e-healthy, mobile devices, and increased personalization driven by advanced data analytics.

• Require centralized enterprise-wide planning and management to prepare for an uncertain future.

• Centralize coordination and tamp down with faculty individuality and autonomy will not be enough to get the job done.

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