Questions, Answers, and New Conversations

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As physicians, we are constantly seeking the answers to questions. What do these symptoms mean? What are the best options for the patient? Do I know enough about the problem or should I seek the advice of another doctor? The answers we find often lead to more questions and stimulate our curiosity to learn. Over time, most of us have developed a healthy skepticism about accepting what appears to be a simple answer to a complex question. We know that life does not usually work that way. Our journal has become aware of challenges to answering complex questions briefly and succinctly  through our Question of the Year, an annual competition to respond to a question of importance to academic medicine. Some of the responses were published in the journal, and authors of a few of the published answers participated in presentations at the AAMC annual meeting. Most recently, the questions explored identity (What is a Doctor? What is a Nurse?), or graduate medical education  (How can we ensure that our graduate medical education system will prepare trainees for practice in new systems of care delivery?). Over time, we have realized that the Question of the Year format could not do justice to the complex issues that we posed to our community. Most thoughtful, scholarly responses to complex questions require analysis of the question and development of a foundation for the answer, which was not generally possible in the space provided. In addition, in some cases rather than an answer, we might benefit from a pursuit of more questions that could lead us on a journey of scholarly discovery.

It was with these limitations in mind that we decided that, starting in 2015, we would attempt to engage our communities in a different way. We will be sun setting the Question of the Year and initiating a new feature, New Conversations, which will encourage thoughtful dialogue around a topic of importance. My January editorial introduces this new feature and lays out the first New Conversations topic. In the coming years, we hope to use New Conversations to examine in depth many important topics of interest to our community, and we plan to announce new topics periodically. For this coming year, we have chosen to explore the influence of health reforms, including the Affordable Care Act, on health care delivery, medical education, and research. We believe that through New Conversations we can help our communities to become informed about the options for health reform in the years ahead. Over the next two years, it is likely that health care will become a major topic for political campaigns. I am hopeful that New Conversations will help our communities to be successful participants in the discussions about the future of health care in our country and in the world. We are seeking New Conversations submissions from a wide array of contributors–anyone is welcome to submit an article for consideration at any time, and we also are working to invite submissions from thought leaders representing a variety of perspectives. International submissions are always welcome, as sharing experiences with health reforms in different settings is an important part of this conversation. The first New Conversations contribution in our January issue is from former Senator Tom Daschle, who provides a broad view of the critical issues facing academic medicine and our health system in the coming years. He identifies five transformational forces–big data, transparency, new payment systems, emphasis on wellness, and scope of practice– that will have critical impact on our academic health centers. I encourage our community to read his article and share it with colleagues.

We look forward to receiving contributions from all members of our community. Submissions should be scholarly contributions; they must follow the journal’s regular submission criteria for Commentaries, Articles, Perspectives, Innovation Reports, Research Reports, or Letters to the Editor, depending on which of these formats you use for your submission. (For more information about those criteria, please see the journal’s Complete Instructions for Authors). We will carry on the conversation outside the pages of the journal as well. This blog will feature a series of roundtable discussions related to the New Conversations contributions that are published in the journal. I also encourage you to discuss New Conversations on Twitter using the hashtag #AcMedConversations by offering your opinions, posing questions, and responding to the questions posed by your colleagues. We will be using the journal’s Twitter handle, @AcadMedJournal, to do the same. Our goal is to keep the New Conversations going throughout the year by using these channels.

We seek the best thinking and creativity of our communities as we consider the effects of health reform and the Affordable Care Act and what messages we would like to give to our political leaders as we look toward the challenges and opportunities of the future.

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