Independent Academic Medical Centers: Q&A with Kimberly Pierce-Boggs

Throughout the country, independent academic medical centers (IAMCs) are providing patients with quality care and students with superior medical education and research opportunities. Though these institutions maintain major medical school affiliations, they operate independently of medical school governance and consequently face challenges and opportunities unique to those of traditional academic medical centers.

To gain some insight into these differences and opportunities, we spoke with Kimberly Pierce-Boggs, the Executive Director of The Alliance of Independent Academic Medical Centers (AIAMC).

We seem to be hearing more about IAMCs than ever before. Why?

While IAMCs certainly aren’t a new concept—they have been around since the beginning of medical education—they may be getting more attention due to their role in helping to address the ongoing shortage of physicians. New medical schools are popping up all over the nation in response to the need for more physicians, but it’s virtually impossible to finance a new hospital with each new training program. Instead, residency programs are partnering with established healthcare institutions that are amenable to adding teaching programs. It is practical and efficient.

Are there any drawbacks to this model?

Though an affiliation between medical schools and existing hospitals is a cost-effective and practical solution for launching training programs, there’s still reason for concern for many members of AIAMC. Because the number of training programs has increased so quickly, many of the existing hospitals can no longer accept any more residents. After all, additional residents mean independent academic medical centers must hire additional physicians who are committed to spending part of their working hours training young physicians. These physicians must be compensated for the time they are not seeing patients. Without additional funding to sustain this infrastructure, we can’t be certain that every new medical school will be able to secure a residency program within an independent academic medical center.

Are there advantages to being an IAMC in the current healthcare climate?

IAMCs are in high demand right now. Residency programs are continuously courting our members because processes at IAMCs tend to be more nimble and efficient when it comes to meeting accreditation requirements. For example, the Accreditation Council for Graduate Medical Education (ACGME) has recently implemented the Clinical Learning Environment Review (CLER) program to provide institutions with periodic feedback on patient safety, health care quality, care transitions, supervision, fatigue management and mitigation, and professionalism. Each institution must undergo a CLER visit every 24 to 36 months to maintain accreditation which requires a high level of participation from the healthcare system’s CEO. Because the Designated Institutional Officer (DIO) of IAMCs report to the institution’s CEO, the CEOs are already engrained in their training programs’ operations and have the necessary information readily available, making most CLER visits engaging and successful. At Universities, on the other hand—where CEOs may be inherently far removed from their medical schools because DIOs report to their Deans instead—attaining GME: C-Suite engagement may be more challenging.

What challenges, if any, do IAMCs face when recruiting physicians?

At IAMCs, patient care is priority, and education and research—while still important—are secondary. At many University-affiliated healthcare systems, education and research are paramount. Physicians who prioritize teaching and research will look for a university-healthcare system. Physicians who are devoted to patient care and are passionate about training future generations of physicians find the perfect fit in an independent academic medical center. Finding physicians with a passion for both can prove challenging. The right candidates are usually personable with high patient satisfaction scores and an interest in the future of healthcare.

What benefits do IAMCs see with recruiting and retention?

IAMCs are very much in tune with local patient populations and healthcare disparities; it becomes part of how physicians at IAMCs teach residents. Often, residents feel so connected to the patient populations, that they decide to stay and serve the community in which they trained. With residency programs, we have a ready pipeline of candidates; our connection to the communities we serve are a recruitment benefit. This approach also helps to retain IAMC physicians committed to quality care.

What is your perspective on the future of IAMCs?

IAMCs will continue to grow and prosper, especially as we continue to find ways to address the physician shortage. We are the efficacious alternative for new medical schools and residency programs. With heightened emphasis on patient care, population health, and cost effectiveness, independent medical centers offer unique solutions to the healthcare challenges of today—and tomorrow.

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