Message from the Dean

I had the opportunity recently to listen to a group of front-line health care providers - nurses, pharmacists, physical therapists, transporters and others - discuss the status of modern health care. One provider spoke of how increasing demands for paperwork and a hectic schedule compro-mise her ability to offer high-quality, personalized patient education and care.

I believe her observations promote an understanding of patients' loss of confidence in their physicians, hospitals and the health care system. This must concern and alarm all health care providers and, as physicians, we must be at the forefront in creating solutions.

The best outcomes are promoted by a partnership between patient and caregivers, with patients taking a greater role in controlling their health. But, unfortunately, it is as difficult for patients to obtain accurate and truly helpful information as it is for physicians to find time to provide it.

An estimated sixty million adults use the Internet to seek health care information. Many, notes American Medical Association President Nancy Dickey, are "getting what is, in effect, a second opinion on what their doctors recommend." Yet, most patients need an explanation of their new data to avoid misunderstandings and anxiety. When their questions go unanswered, they turn to friends, family and strangers for information, which is frequently anecdotal and potentially harmful.

Ironically, while we as providers know more about disease and outcomes than ever before, we have far less time to share our knowledge with patients: Managed care demands that providers improve efficiency. Business economics demand that physicians see more patients each week. More and sicker patients are seen in outpatient settings. The severity of inpatient illnesses is greater, placing an increased demand on nurses. And tertiary hospitals are effectively becoming intensive care units. All of this is occurring while federal and state licensing/accrediting agencies are increasing their demands for rigorous record keeping.

These issues have provoked me to commit the School to an initiative called Indiana's Eye on Patients, undertaken with the Indiana State Medical Association and the Indiana Hospital & Health Association. Our goal is to improve how care is delivered to Hoosiers based on what they tell us they need and want. Our strategy is to identify specific steps that hospitals and physicians can take to improve care and restore public confidence in their institutions and professions. Patients' needs for information and education are essential to achieve quality patient care, and our role as providers is essential to providing it.

Robert W. Holden, MD '63
Dean, Indiana University School of Medicine
Walter J. Daly Professor