Institutional change

Experiences in two departments

H. J. Humphrey, L. B. Sorensen, Bruce Alan Buehler

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Though the principle may seem simple or fundamental, it has been our experience that the best way to develop clinician-educators in an academic setting is to value their contributions. This means that those contributions must lead to promotion, they should be valued by colleagues, they must be valued by the administration and the chairman, and they must be considered when determining faculty salary. As faculty members perceived that they were valued for teaching and clinical service, and would not be punished for the amount of time they were spending in these endeavors, there was a clear group of faculty who came forward to take on a primary teaching role. This group was not limited to general pediatricians or ambulatory pediatricians, but included some specialists who felt that their pediatric background was sufficient for them to teach in a primary care setting. Two of our leading teachers in the generalist curriculum are specialists in nephrology and hematology/oncology. Although this requires them to go back and increase their knowledge in general pediatrics, it is far less difficult according to these faculty members than they expected. Our specialists continue to maintain their specialty practices, but have oriented their didactic lectures and clinical teaching to specialty and general aspects of pediatrics. It is not difficult to teach about parenting and psychosocial skills when describing a complicated specialty patient and to orient the students and residents to the general care of such a patient. Although the majority of strategies described in this article deal with departmental and college initiatives, the reason that these strategies have become an integral part of the Department of Pediatrics is the changing health care environment in Nebraska. Managed care has mandated that physicians be more flexible and be willing to take on a primary care role within their specialty. This has made the transition for many faculty much easier and has been reinforced by financial reimbursement for their services. The transition would not have been as easy had there been no movement of the community toward primary care, or no shift in the university's interest in primary care as a mechanism for providing sufficient patient numbers to fulfill our teaching missions. Clinical research has become the area of focus for many of the primary care physicians and some specialists in the past few years, and the university is in the process of developing a clinical research center to allow for outpatient studies. Although the strategies summarized are specific to the University of Nebraska Medical Center, many of the principles could be adapted to other teaching programs. The most basic element is to tie reward and recognition to efforts in primary care.

Original languageEnglish (US)
JournalJournal of General Internal Medicine
Volume12
Issue numberSUPPL. 2
StatePublished - May 6 1997

Fingerprint

Primary Health Care
Teaching
Pediatrics
Nephrology
Salaries and Fringe Benefits
Parenting
Managed Care Programs
Primary Care Physicians
Hematology
Reward
Research
Curriculum
Outpatients
Students
Delivery of Health Care
Physicians
Pediatricians

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Humphrey, H. J., Sorensen, L. B., & Buehler, B. A. (1997). Institutional change: Experiences in two departments. Journal of General Internal Medicine, 12(SUPPL. 2).

Institutional change : Experiences in two departments. / Humphrey, H. J.; Sorensen, L. B.; Buehler, Bruce Alan.

In: Journal of General Internal Medicine, Vol. 12, No. SUPPL. 2, 06.05.1997.

Research output: Contribution to journalReview article

Humphrey, HJ, Sorensen, LB & Buehler, BA 1997, 'Institutional change: Experiences in two departments', Journal of General Internal Medicine, vol. 12, no. SUPPL. 2.
Humphrey HJ, Sorensen LB, Buehler BA. Institutional change: Experiences in two departments. Journal of General Internal Medicine. 1997 May 6;12(SUPPL. 2).
Humphrey, H. J. ; Sorensen, L. B. ; Buehler, Bruce Alan. / Institutional change : Experiences in two departments. In: Journal of General Internal Medicine. 1997 ; Vol. 12, No. SUPPL. 2.
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