title: Process and accomplishment in academic medicine.
abstract: Medical academic systems are characterized by interplay between accomplishment and process. The term accomplishment refers to fulfillment of the system's original goals, such as education, research and medical care, whereas the term process refers to the culture and structure, which are developed to pursue these goals. A mathematical model is developed to simulate the mechanisms that govern growth of medical systems over time. Because system performance is easier to measure by process than accomplishment, in the long run investments in growth are shifted away from accomplishment towards process. In all aging medical systems alike, the proportion of process tends to increase at the expense of accomplishment.
authors.affiliation: Gastroenterology Section, Portland VA Medical Center and Oregon Health & Science University, P3-GI, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239, USA. sonnenbe@ohsu.edu
authors.forename: Amnon
authors.initials: A
authors.lastname: Sonnenberg
mesh_terms: D000046:Academic Medical Centers; D003198:Computer Simulation; D003695:Delivery of Health Care; D006761:Hospitals; D006801:Humans; D008511:Medicine / Q000639:trends*; D008962:Models, Theoretical; D012106:Research / Q000639:trends*; D013038:Specialization; D013997:Time Factors