Dr. Good: This is Dr. Michael Good. I’m CEO of University of Utah Health and the Executive Dean of the Spencer Fox Eccles School of Medicine here at the University of Utah. Today, we are honored to have Dr. David Skorton as our guest on this Scope Studio podcast.
Dr. Skorton is President and CEO of the Association of American Medical Colleges, or AAMC, the organization that represents our nation’s medical schools, teaching hospitals, health systems, and academic societies.
Dr. Skorton, thanks for joining us today. And to get us started, share with our audience a few comments about the work of AAMC and maybe a few of the details about the important national AAMC meeting that is taking place this week right here in Salt Lake City.
Dr. Skorton: Well, Dr. Good, thank you so much for interviewing me on this podcast. Congratulations on this podcast and congratulations on all the things you are doing at the University of Utah. Very, very impressive work. Very important not only for this place, not only for this state, but for our country and the world. Congratulations to you.
Overview of the Association of American Medical Colleges (AAMC) and its Four Core Missions
Well, the AAMC is an organization that was founded in the 1870s. No, I was not there at the time. It was chartered as a medical education organization, and over the generations really has developed four missions. One is medical education, the second, of course, is healthcare, the third is biomedical research, and the fourth more recently we’re calling community collaboration. That is, solving problems in our communities by listening to the authentic voices of those who are living through that.
And what we’re doing here in beautiful Salt Lake City, which had a beautiful snowstorm this morning and is now sunny and gorgeous, is we’re having a meeting of our Council of Faculty and Academic Societies.
The AAMC consists of all of the accredited MD-granting medical schools in the country, 157 of them, all the major teaching hospitals and health systems, about 400 of them, and nearly 80 academic societies.
And we’re here today, and quite a bit of it thanks to your hospitality and kindness, to visit this wonderful place and to talk about what’s happening with the faculty, the teachers, the researchers, those who develop patient care and community things. So we’re here for a big meeting and glad to be here with you.
Dr. Good: Spencer Fox Eccles, whose family and philanthropic foundations provided a generous endowment gift to name our medical school, has repeatedly stated that, “No state or region can truly be great without a world-class medical center at its nucleus.”
You’ve visited many of the medical schools and medical centers across America. Share with us your thoughts about the overall value that an academic medical center brings to its community.
The Value of Academic Medical Centers to Their Communities
Dr. Skorton: Well, first of all, what a wonderful quote. I so much wish I had said that rather than learning that someone else did. What a generous, amazing forward-looking family that has done so much for so many.
What is it about an academic medical center that contributes so much to its community and beyond? Dr. Good, how much time do you have? Because we could talk about this one all day long.
Number one, of course, is the delivery of the very best medical care, preventive diagnostic/therapeutic medical care.
An article published in the “Journal of the American Medical Association” showed that survival in an academic health center for a patient is about 20% better than it is in a non-academic health center. We have a lot of, of course, wonderful hospitals that are not academic health centers, but the healthcare is even better in the academic health centers. So, of course, they deliver healthcare.
Secondly, the research, the new knowledge that helps us get past so many hurdles. Think about this horrendous pandemic that we’re just working our way out of. Think about Operation Warp Speed. In about a year, we were able to develop mRNA vaccines to prevent millions of more deaths. That based on over 15 years of fundamental research done at places like the University of Utah through National Institutes of Health funding. So biomedical research is the second thing that they do.
Thirdly, education of new generations, and not just physicians, as important as that is, but nurses, and pharmacists, and those in the public health field, and others. That’s another function.
Working with the communities, so very, very important. And beyond all those things, academic medical centers are commonly among the largest, if not the largest, employer in their area, and therefore contributing to the vitality of the economy, not just in the local area but nationwide. And so you name it, academic medical centers do it and do it well.
The Importance of Medical Research Conducted at Medical Schools
Dr. Good: That’s great. You spoke to patient care, research, education, and community collaboration, and that’s certainly the mission of excellence we seek here at the University of Utah.
Dr. Skorton, you’re a physician-scientist yourself, and you’ve led research-intensive medical centers, you’ve served as the president of research-intensive universities, and now you lead our national organization of medical schools. You mentioned the vaccine, but maybe expand a little bit about why the research conducted at the nation’s medical schools is so important to our country.
Dr. Skorton: So there’s a wide variety of reasons. These are wonderful questions you’re asking. I think each one is worthy of its own podcast. It’s so beautiful here, you’ve got to have me out again and again so I can do like 10 podcasts and answer each one. But I’ll try to make it brief.
Using Research to Understand the World Within and Around Us
Research is important for two big reasons. One, which sounds very puffy and high-minded, is just to understand things better about the world within us and around us.
And it’s by understanding the world better within us and around us that we can do a better job of living our lives, that we can do a better job of preparing that world for our kids and our grandkids and those that come beyond. And so just understanding things is one thing.
Using Research to Solve Real-world Problems
And then secondly, applying those understandings to solve real-world problems.
Here at the University of Utah, all day long and all night long, every day and every night, I know without asking you, you have researchers who are blazing new trails to solve problems, some of which may be finding things that haven’t even been thought about before in the context of anything, other problems or otherwise.
And you have a great tradition here for doing both the most fundamental research of understanding life, and health, and disease, and also solving very, very specific problems, and coming up with new ideas of how to do things.
And I want to embarrass you, Dr. Good, by saying that you did something in the research and development sphere some years ago that changed medical education, and that is creating a patient simulator.
There’s all kinds of talk now about artificial intelligence and all kinds of things that we can do, and you did something just a few years ago, Dr. Good, that really changed our ability to learn, to teach, and to excel based on research of a different type than fundamental basic biomedical research, but was very, very important. So that’s a little bit of what the centers do.
The Research Enterprise
By the way, the research enterprise is also an enterprise. We train students, those with MDs, those with MDs and PhDs, those with PhDs, those post-doctorals. We also buy goods and services from around the country and around the world. We also create jobs indirectly because of suppliers and vendors to those research operations. So, again, it’s a positive economic impact beyond the positive impact of the research itself.
Dr. Good: I obviously couldn’t agree more with those comments. And actually, one of the reasons I like working in the academic medical center is to create that environment where innovation and new ideas can be tested, as you say, whether they’re on the wet bench in the laboratory or whether they’re in the computer, and some of these new analytic assessments, and so on.
The reason I was able to innovate is because I was in one of those really productive environments, and that’s what we’re certainly trying to do, to create that environment for our faculty.
The Role of Medical Schools and Improving Community Health
I’ve shared with you previously I think the AAMC does an exceptional job helping medical school deans like me understand the importance of community collaboration and the way we truly become anchor institutions in our community.
And as we shared with you, our medical school and university are embarking on this ambitious project to build a new hospital and health center in the western portions of the Salt Lake Valley, areas which have health disparities such as decreased life expectancy and incidents of higher diseases. Your thoughts on the role of medical schools and improving community health?
Dr. Skorton: Very, very, very important. It’s another example, Dr. Good, of thinking broadly about the mission of the academic health center in not only helping those fortunate folks who can actually get here for care, but those who can’t get here.
And one of the things that we’ve learned in recent couple of decades, and before that, but especially recent decades, and it’s been driven home very directly during the COVID-19 pandemic, is that of all the things that affect our health . . . Certainly our family histories, our genetics affect our health for sure. Certainly how we behave and try to take care of ourselves, that affects it for sure. And obviously, healthcare affects it for sure. But one of the biggest factors that affects all of our health is the environment in which we live.
Do we have shelter? Do we have the blessing of a home? Do we have nutritious food available? Do we have access to healthcare, high-quality healthcare, and is it accessible to us? Do we have coverage to pay for it? And so on.
And so thinking about those so-called social determinants of health has brought us to think about the community broadly beyond the individuals who come to the Health Sciences Center.
And one axiom that I like to think about is that if you want to find out about a problem, ask the people who are experiencing that problem. If you want to find out about injustice, ask the people who are suffering it, and you’ll learn two things. You’ll learn a direct point of view, a direct perspective on what it is that’s really happening, and you’ll get some very, very important and authentic and wise ideas about how we can begin to work our way through it.
And what you’re doing is thinking broadly, as you absolutely have to do and as you’re showing others around the country to do, about your responsibility not just to those lucky folks who get here to this magnificent Health Sciences Center, but to those everywhere in the state of Utah.
By the way, your good work at the University of Utah touches people all over the world. When you do a research project and it gets published in a research journal, there are no boundaries, or visas, or anything on that information. It gets spread around the world to seed other ideas for other investigators.
And when you educate a student or a resident or a fellow and that person goes back to another community, if they make the mistake of not wanting to stay in Salt Lake City, you’re spreading the wealth very, very broadly.
So you help communities in many, many senses: the communities around the state and beyond, those that are suffering inequities, and the broader community of researchers, educators, and practitioners literally around the world.
Dr. Good: Well, thank you. Dr. Skorton, we’ve been really honored to have you visiting us here at the University of Utah today, and especially for joining us for this Scope Studio podcast. We really appreciate the way you and your organization provide valuable expertise and lessons and share them with our faculty, with our students, and with our staff. Thank you for all you do to advance the health of America through our nation’s medical schools and teaching hospitals.
Dr. Skorton: Thank you, Dr. Good. And I could wish nothing more than for you to just keep doing what you’re doing, keep swinging for the fences. You’re getting the job done. Thank you for having me.