Hartford Medicine Program The John A. Hartford Foundation Fourth Quarter Board Meeting  December 7, 2007 Gavin W. Hougham,...
JAHF Medicine Commitment <ul><li>Foundation goal is to increase the nation’s capacity to provide effective and affordable ...
Why Medicine? <ul><li>As physicians have traditionally been central to the health care needs of older adults… </li></ul><u...
U.S. Physician Workforce <ul><li>Physicians are central </li></ul><ul><li>Diagnose and treat </li></ul><ul><li>Prescribe m...
JAHF Medicine Strategy <ul><li>1) All fields of medicine </li></ul><ul><ul><li>Primary to specialty care </li></ul></ul><u...
Context and Barriers <ul><li>Getting attention is a challenge </li></ul><ul><li>Diversification/specialization </li></ul><...
JAHF Medicine Tactics <ul><li>Capitalize on Hartford brand  </li></ul><ul><li>Manage existing programs </li></ul><ul><li>C...
JAHF Medicine Commitments <ul><li>1983-2007 (229 grants): $161m  </li></ul><ul><li>Current (56 grants): $59.8m </li></ul><...
Number of Certified Geriatricians   Source:  ADGAP Status of Geriatrics Workforce Study, 2007 , yearly totals (n)
Growth in Geriatrics Programs  Source:  ADGAP Status of Geriatrics Workforce Study, 2007 24 4.0 9.6 2007 18 Total academic...
Percent of U.S. Medical Schools at which Geriatrics Faculty Teach Geriatrics in Other Specialties Source:  ADGAP Status of...
Medical Students Better Prepared Source:  AAMC, Medical School Graduation Questionnaire  75% 72% 70% 69% 65% % medical stu...
Strategy One: All Physicians Medical Students Interns, Residents Fellows, Junior Faculty  Senior Faculty, Practicing MDs  ...
Strategy One: All Physicians Medical Students Interns, Residents Fellows, Junior Faculty  Senior Faculty, Practicing MDs  ...
Strategy One: All Physicians <ul><ul><li>Medical Students: </li></ul></ul><ul><ul><li>Curriculum Education Dissemination (...
Strategy One: All Physicians Interns, Residents Fellows, Junior Faculty  Source: Adapted from JAHF Strategic Plan 2006 Spe...
Strategy One: All Physicians <ul><ul><li>Interns/Residents: </li></ul></ul><ul><ul><li>Geriatrics for Specialty Residents ...
Strategy One: All Physicians Fellows, Junior Faculty  Source: Adapted from JAHF Strategic Plan 2006 Other Specialties Deve...
Strategy One: All Physicians <ul><ul><li>Surgical Specialties (started 1992) </li></ul></ul><ul><ul><ul><li>AGS geriatrics...
Medical Students Interns, Residents Fellows, Junior Faculty  Senior Geriatrics Faculty  Source: Adapted from JAHF Strategi...
<ul><ul><li>Medical Students: </li></ul></ul><ul><ul><li>Medical Student Training in Aging Research (1,086) </li></ul></ul...
<ul><ul><li>Medical Students: </li></ul></ul><ul><ul><li>Medical Student Training in Aging Research  </li></ul></ul><ul><u...
Strategy Two: Geriatricians Fellows, Junior Faculty  Senior Geriatrics   Faculty Source: Adapted from JAHF Strategic Plan ...
Strategy Two: Geriatricians <ul><ul><li>Geriatrics Fellows/Junior Faculty: </li></ul></ul><ul><ul><li>JAHF CoE – Centers o...
Strategy Two: Geriatricians Senior Geriatrics Faculty Source: Adapted from JAHF Strategic Plan 2006 CoEs, Leadership, Inst...
Strategy Two: Geriatricians <ul><ul><li>Geriatrics Senior Faculty: </li></ul></ul><ul><ul><li>JAHF CoE – Centers of Excell...
Current JAHF Medicine Grants <ul><ul><li>Field-wide: </li></ul></ul><ul><ul><li>Status of Geriatrics Workforce </li></ul><...
Balancing Priorities Trainees All of Medicine Generalists Faculty development Institutions Top down What works Practicing ...
Future Medicine Programs? <ul><li>Strategy One: </li></ul><ul><li>American Association of Medical Colleges - Curriculum </...
Summary <ul><li>JAHF investment and payoffs in medicine significant </li></ul><ul><li>JAHF programs “gold standard” and fi...
For further information on medicine area programs at the Foundation: Gavin W. Hougham, Ph.D. Senior Program Officer The Jo...
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Slide 1 - Welcome to The John A. Hartford Foundation's Website

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  • [[Copyright 2007 The John A. Hartford Foundation. All rights reserved]]
  • Slide 1 - Welcome to The John A. Hartford Foundation's Website

    1. 1. Hartford Medicine Program The John A. Hartford Foundation Fourth Quarter Board Meeting December 7, 2007 Gavin W. Hougham, PhD © 2007 The John A. Hartford Foundation
    2. 2. JAHF Medicine Commitment <ul><li>Foundation goal is to increase the nation’s capacity to provide effective and affordable care to its rapidly increasing older adult population. </li></ul>
    3. 3. Why Medicine? <ul><li>As physicians have traditionally been central to the health care needs of older adults… </li></ul><ul><li>JAHF strategy has focused on preparing physicians. </li></ul>
    4. 4. U.S. Physician Workforce <ul><li>Physicians are central </li></ul><ul><li>Diagnose and treat </li></ul><ul><li>Prescribe medication </li></ul><ul><li>Drive medical research </li></ul><ul><li>Train/supervise other professionals </li></ul><ul><li>Most services physician-ordered </li></ul><ul><li>Central to team care </li></ul><ul><li>780,000 physicians in U.S. </li></ul>Source: Impact of the Aging Population on the Health Workforce in the U.S., 2005.
    5. 5. JAHF Medicine Strategy <ul><li>1) All fields of medicine </li></ul><ul><ul><li>Primary to specialty care </li></ul></ul><ul><ul><li>Surgical and related specialties </li></ul></ul><ul><ul><li>Internal medicine specialties </li></ul></ul><ul><li>2) Geriatric medicine </li></ul><ul><ul><li>Ensure adequate pipeline </li></ul></ul><ul><ul><li>Train future faculty and leaders </li></ul></ul><ul><ul><li>Support of field-wide growth </li></ul></ul>
    6. 6. Context and Barriers <ul><li>Getting attention is a challenge </li></ul><ul><li>Diversification/specialization </li></ul><ul><li>Competition, politics, turf </li></ul><ul><li>Academic medicine is hard </li></ul><ul><li>Geriatrics remote to young MDs </li></ul><ul><li>Ageism is everywhere </li></ul>Source: Impact of the Aging Population on the Health Workforce in the U.S., 2005.
    7. 7. JAHF Medicine Tactics <ul><li>Capitalize on Hartford brand </li></ul><ul><li>Manage existing programs </li></ul><ul><li>Create networks </li></ul><ul><li>Develop new programs </li></ul><ul><li>Broker resources & knowledge </li></ul><ul><li>Convene stakeholders </li></ul><ul><li>Partner with other foundations </li></ul>
    8. 8. JAHF Medicine Commitments <ul><li>1983-2007 (229 grants): $161m </li></ul><ul><li>Current (56 grants): $59.8m </li></ul><ul><li>Leverage, 2002-2006: $178m </li></ul>
    9. 9. Number of Certified Geriatricians Source: ADGAP Status of Geriatrics Workforce Study, 2007 , yearly totals (n)
    10. 10. Growth in Geriatrics Programs Source: ADGAP Status of Geriatrics Workforce Study, 2007 24 4.0 9.6 2007 18 Total academic staff 3.3 MD fellows 7.5 MDs 2001 Academic staff 59 2007 42 % programs with budgets over $1M 2001 Size of programs
    11. 11. Percent of U.S. Medical Schools at which Geriatrics Faculty Teach Geriatrics in Other Specialties Source: ADGAP Status of Geriatrics Workforce Study, 2007 87% 2007 75% 2005
    12. 12. Medical Students Better Prepared Source: AAMC, Medical School Graduation Questionnaire 75% 72% 70% 69% 65% % medical students who feel prepared to care for older adults 2007 2006 2005 2004 2003
    13. 13. Strategy One: All Physicians Medical Students Interns, Residents Fellows, Junior Faculty Senior Faculty, Practicing MDs Source: Adapted from JAHF Strategic Plan 2006
    14. 14. Strategy One: All Physicians Medical Students Interns, Residents Fellows, Junior Faculty Senior Faculty, Practicing MDs Source: Adapted from JAHF Strategic Plan 2006 Curriculum, Summer students, Interest groups
    15. 15. Strategy One: All Physicians <ul><ul><li>Medical Students: </li></ul></ul><ul><ul><li>Curriculum Education Dissemination (40+ schools) </li></ul></ul><ul><ul><ul><li>(AAMC national consensus conference held 2007) </li></ul></ul></ul>
    16. 16. Strategy One: All Physicians Interns, Residents Fellows, Junior Faculty Source: Adapted from JAHF Strategic Plan 2006 Specialties, Chief Residents, Pilot grants Senior Faculty, Practicing MDs
    17. 17. Strategy One: All Physicians <ul><ul><li>Interns/Residents: </li></ul></ul><ul><ul><li>Geriatrics for Specialty Residents (64 schools so far) </li></ul></ul><ul><ul><ul><li>(spread geriatrics to trainees in surgical spec) </li></ul></ul></ul><ul><ul><li>Chief Resident Immersion Training (just starting) </li></ul></ul><ul><ul><ul><li>(spread geriatrics to all specialties of medicine) </li></ul></ul></ul><ul><ul><li>Other pilots through CoEs </li></ul></ul>
    18. 18. Strategy One: All Physicians Fellows, Junior Faculty Source: Adapted from JAHF Strategic Plan 2006 Other Specialties Development awards, Curriculum, Specialty societies, Pilot grants Senior Faculty, Practicing MDs
    19. 19. Strategy One: All Physicians <ul><ul><li>Surgical Specialties (started 1992) </li></ul></ul><ul><ul><ul><li>AGS geriatrics for surgical specialties (63 Jahnigens) </li></ul></ul></ul><ul><ul><li>Specialties of Internal Medicine (started 1994) </li></ul></ul><ul><ul><ul><li>American Association of Internal Medicine (40 Williams) </li></ul></ul></ul><ul><ul><li>Paul Beeson Scholars program (135) </li></ul></ul><ul><ul><li>Hospitalists: Society of Hospital Medicine </li></ul></ul><ul><ul><li>Cardiology: American College of Cardiology </li></ul></ul>
    20. 20. Medical Students Interns, Residents Fellows, Junior Faculty Senior Geriatrics Faculty Source: Adapted from JAHF Strategic Plan 2006 Other Specialties Strategy Two: Geriatricians Summer students, Interest groups
    21. 21. <ul><ul><li>Medical Students: </li></ul></ul><ul><ul><li>Medical Student Training in Aging Research (1,086) </li></ul></ul>Strategy Two: Geriatricians
    22. 22. <ul><ul><li>Medical Students: </li></ul></ul><ul><ul><li>Medical Student Training in Aging Research </li></ul></ul><ul><ul><li>NIA, other foundations </li></ul></ul><ul><ul><li>Some early students now faculty </li></ul></ul><ul><ul><li>Stacy T. Lindau, MD, MA </li></ul></ul>NEJM 2007:Today (NBC), CBS News, USA Today, Washington Post, New York Times, Newsweek, NPR, BBC… Strategy Two: Geriatricians
    23. 23. Strategy Two: Geriatricians Fellows, Junior Faculty Senior Geriatrics Faculty Source: Adapted from JAHF Strategic Plan 2006 CoEs, Junior Faculty Development Interns, Residents Pilot grants
    24. 24. Strategy Two: Geriatricians <ul><ul><li>Geriatrics Fellows/Junior Faculty: </li></ul></ul><ul><ul><li>JAHF CoE – Centers of Excellence (500 trained) </li></ul></ul><ul><ul><ul><li>Geriatric Medicine (22 + 3 pending) </li></ul></ul></ul><ul><ul><ul><li>Geriatric Psychiatry (2) </li></ul></ul></ul><ul><ul><li>Hartford Health Outcomes Research Scholars (27) </li></ul></ul><ul><ul><li>Paul Beeson Scholars (135) </li></ul></ul>
    25. 25. Strategy Two: Geriatricians Senior Geriatrics Faculty Source: Adapted from JAHF Strategic Plan 2006 CoEs, Leadership, Institutions
    26. 26. Strategy Two: Geriatricians <ul><ul><li>Geriatrics Senior Faculty: </li></ul></ul><ul><ul><li>JAHF CoE – Centers of Excellence </li></ul></ul><ul><ul><ul><li>Geriatric Medicine (22 + 3 pending) </li></ul></ul></ul><ul><ul><ul><li>Geriatric Psychiatry (2) </li></ul></ul></ul><ul><ul><li>CoE Network Resource Center </li></ul></ul><ul><ul><li>Geriatrics Leadership Development (22) </li></ul></ul><ul><ul><li>New Division Chiefs Awards (Supiano at Utah) </li></ul></ul>
    27. 27. Current JAHF Medicine Grants <ul><ul><li>Field-wide: </li></ul></ul><ul><ul><li>Status of Geriatrics Workforce </li></ul></ul><ul><ul><ul><li>(gold standard data on field) </li></ul></ul></ul><ul><ul><li>Institute of Medicine Healthcare Workforce Study </li></ul></ul><ul><ul><ul><li>(potential for new JAHF and field-wide ideas) </li></ul></ul></ul>
    28. 28. Balancing Priorities Trainees All of Medicine Generalists Faculty development Institutions Top down What works Practicing physicians Geriatrics Specialists Curriculum development Individuals Bottom up New areas
    29. 29. Future Medicine Programs? <ul><li>Strategy One: </li></ul><ul><li>American Association of Medical Colleges - Curriculum </li></ul><ul><li>American College of Surgeons - Quality </li></ul><ul><li>National Board of Medical Examiners – Education </li></ul><ul><li>Strategy Two: </li></ul><ul><li>Pending 3 new CoEs in geriatric medicine - Faculty </li></ul><ul><li>Possible new CoE in geriatric psychiatry – Faculty </li></ul><ul><li>American Association of Geriatric Psychiatry - Faculty </li></ul>
    30. 30. Summary <ul><li>JAHF investment and payoffs in medicine significant </li></ul><ul><li>JAHF programs “gold standard” and field-changing </li></ul><ul><li>Academic geriatricians reaching senior leadership </li></ul><ul><li>Visibility of geriatrics within medical schools rising </li></ul><ul><li>Geriatrics spreading to other specialties </li></ul>
    31. 31. For further information on medicine area programs at the Foundation: Gavin W. Hougham, Ph.D. Senior Program Officer The John A. Hartford Foundation 55 East 59 th Street New York, NY 10022 [email_address] www.jhartfound.org Office: 212.832.7788 Fax: 212.230.2957

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