Implications of academic medicine's failure to recognize clinical excellence.
OBJECTIVE
To better understand the implications of inadequately recognizing clinical excellence in academia by exploring the perspectives of clinically excellent faculty within prominent American departments of medicine.


METHODS
Qualitative study.


METHODS
8 academic institutions.


METHODS
24 clinically excellent department of medicine physicians.


METHODS
Between March 1 and May 31, 2007, investigators conducted in-depth semi-structured interviews with 24 clinically excellent physicians at leading academic institutions. Interview transcripts were independently coded by two investigators and compared for agreement. Content analysis identified themes related to clinical excellence in academia.


RESULTS
Twenty informants (83%) were Associate Professors or Professors, 8 (33%) were females, and the physicians hailed from a wide range of internal medicine specialties. The mean percent effort spent in clinical care by the physicians was 48%. The five domains that emerged related to academic medicine's failure to recognize clinical excellence were: (1) low morale and prestige among clinicians, (2) less than excellent patient care, (3) loss of talented clinicians, (4) a lack of commitment to improve patient care systems, and (5) fewer excellent clinician role models to inspire trainees.


CONCLUSIONS
If academic medical centers fail to recognize clinical excellence among its physicians, they may be doing a disservice to the patients that they pledge to serve. It is hoped that initiatives aiming to measure clinical performance in our academic medical centers will translate into meaningful recognition for those achieving excellence such that outstanding clinicians may feel valued and decide to stay in academia.
Durso
Samuel C
SC
Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, 5200 Eastern Avenue, Baltimore, MD 21224, USA.
Christmas
Colleen
C
Kravet
Steven J
SJ
Parsons
Gregory
G
Wright
Scott M
SM
D000046:Academic Medical Centers / Q000458:organization & administration / Q000639:trends; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008297:Male; D010820:Physicians / Q000458:organization & administration / Q000639:trends; D012189:Retrospective Studies