The Value of Studying History
Reviewing the next to final draft of “Looking Back to Look Forward: AUPHA at 70” during the last several weeks deepened my understanding of AUPHA’s history. Despite being a member since 1983, I either did not know or more likely did not remember details of much of our history. This edit also made me aware of how dependent AUPHA is on smart, committed and hardworking faculty. Especially in the early years of AUPHA, we were led by individuals with a deep understanding of healthcare management and the importance of education. They seemingly had a strongly held vision of what our programs and our association should become at a time when there were no clear guidelines to follow. I can tell you that even with information, history and select guidelines in place, all associations are difficult to lead. Many educational institutions struggle today and we all experience the challenges of preparing our students to expand access to cost effective and high quality care. It serves us well to reflect on their early efforts to build the field. Perhaps we can learn from them.
The history addresses specific challenges AUPHA faced over 70 years and demonstrates how we successfully defined and addressed challenges. This blog is not about those details, however. You will get those soon enough. I want to talk about four themes that I observed across the chapters that help define AUPHA’s past and perhaps may help us manage our collective future. First, in those early years especially, AUPHA constituted the field. By default, there were no other academic programs that had an interest in or could address the systematic preparation of healthcare managers. The founders of AUPHA were first to recognize that need and develop a plan to address it. AUPHA defined and represented the field in its totality. That was good in that everyone looked to us to delineate the skills required of a healthcare leader. These academic leaders were themselves learning on the job, however, because there was no roadmap. As AUPHA developed and grew, specialization arose within AUPHA members and pressure for domains to move apart and focus on a particular aspect of the core mission. As examples, over the years some business schools and a few public health schools have split from AUPHA, others with healthcare management goals never joined AUPHA, and AcademyHealth, Academy of Management and other research oriented associations have attracted faculty with a primary research focus. At the same time, however, we included undergraduate programs thus greatly expanding AUPHA’s scope. We must keep all programs engaged in the diverse aspects of healthcare management education as engaged members if history guides us. We must maintain a “big tent” as some have said in the past. Why? As many have argued before me, the diversity of academic home, academic discipline and emphasis on educational outcomes make healthcare management unique among our academic peers. That rich diversity of perspectives makes AUPHA and the field of healthcare management stronger.
Second, research must be maintained as a crucial part of our portfolio. AUPHA does a great job with regard to the pedagogy of healthcare management education through our meetings, network and Journal. We must enhance our ability to lead the discovery and dissemination of new knowledge relevant to healthcare management, however, to maintain leadership in our field. The early years of AUPHA were characterized by faculty who led their programs’ education and research missions. Many examples exist but John D. Thompson comes first to my mind. His passion for education and training future leaders was only equaled by his understanding of healthcare delivery. He was a part of the team out of Yale that in the late 1970s developed what became Medicare’s DRG reimbursement system. We have as a vital legacy, the John D. Thompson Prize designed to recognize those early career healthcare administration faculty with outstanding potential. An examination of the winners of this prize starting with Michael Morrisey, now chair at Texas A & M Health Sciences Center, through Elizabeth Bradley, now President of Vassar College, to the 2017 winner, David Jones from Boston University demonstrates the quality of emerging research faculty among our members. The challenge is to determine how best to keep these individuals connected to AUPHA in a meaningful way.
Third, AUPHA evolved with the aid of our productive ties to practitioners. From the start, our leaders recognized that preparation of competent healthcare leaders could not be done solely through classroom learning. Field experiences, internships, residencies and/or fellowships constituted a significant portion of the educational process from day one. Programs devote significant resources toward ensuring practice-based opportunities for students. Graduates certainly love and appear to benefit greatly from those experiences. Many programs successfully integrate practitioners more formally into the educational process through guest lectures, executive in residence, and hiring former practitioners as full time faculty. Alternative models exist to meet these goals and we all learn from the experiences of our member colleagues. Most importantly, however, AUPHA began with and maintains close ties to the organizations that our alumni join to further their careers. ACHE, AHA, MGMA, HIMSS, HFMA and others were instrumental throughout the growth and development of AUPHA. Keeping those ties, formally and informally, represent some of the key challenges and opportunities going forward.
Fourth, throughout our history, AUPHA member programs do more than educate, they prepare students for successful careers in healthcare management. The practice experiences mentioned above are a part of this preparation but our program faculty and staff engage the students in the professionalism necessary for healthcare leadership. At both the graduate and undergraduate levels, modeling professional behavior occurs in and out of the classroom and encompasses dress, language, social behavior and other features. Crucially, a hallmark of our alums is a strong social responsibility that includes ethics, a moral foundation, and commitment to community service. The business aspects of healthcare leadership require a broad array of skills similar across all industries. Our forefathers, however, realized that healthcare is different.Chasing the newest idea has become fashionable in business and politics but we all may benefit from keeping an eye on history. While that sounds like a recipe to never change (a disaster), it represents a cautionary statement. As we contemplate directions for our future, AUPHA must consider the reasons for the big tent, integration of research, connection to practice and recognition the uniqueness of healthcare. The future is strong and we get their by learning from the past.
See you all soon in Philadelphia