ATS 2018 kicked off with the Opening Ceremony, featuring distinguished physician, educator, and medical scientist Darrell G. Kirch, MD, president and chief executive officer of the Association of American Medical Colleges.

“It is high time that we exert our leadership for the sake of the people we serve,” said Darrell G. Kirch, MD, “Our patients depend on us, and future generations of patients depend on us.” During the keynote address, Dr. Kirch laid out six key challenges facing health care around the world. Clinicians are best equipped to meet all six.

The first challenge is the disruption of health care by successive mergers, acquisitions, and breakups. Consolidating medical practices, hospitals, and systems into ever-larger business units gives the anatomic appearance of integration but fails to achieve physiologic integration.

“We do a much better job of rescuing people than we do in keeping them well,” he said. “And we are spending more than we can afford. Clinicians have ceded leadership to others, and healthcare has lost the balance between business rigor and clinical sensitivity.”

The second challenge: living in a post-truth era where personal belief, opinion, and emotion mean more than evidence. There is an existential challenge to medicine. The best people to speak to the value of science are the people who do it.

The third challenge is education. Not education spending, but the process of education. Our students are tired of the sage on the stage. They are ready to adapt new technology, apps, artificial intelligence, virtual reality, and high-definition simulation to learning.”

Inequality is the fourth key challenge. There is a straight line between income disparities and health disparities. One of the best predictors of health status is income and educational status.  Health inequalities are some of the most pernicious challenges to health.

The fifth challenge is burnout and depression. Just as “to err is human” focused attention on quality in health care, the spotlight today must shine on the reality that physicians are not immune to human frailties.

Lack of leadership is the final challenge. We must face the brutal realities and set the course to prevail against these challenges. It is so easy to get inspired to lead in health care because of our foundation in clinical ethics. Do good for patients, avoid harm, respect their autonomy, and build social justice. It is not ethically correct to have haves and have nots in health care.

About the speaker: Dr. Kirch speaks and publishes widely on the need for transformation in the nation’s health care system, and how academic medicine can lead change across medical education, biomedical research, and patient care. His career spans all aspects of academic medicine and includes a leadership role at the National Institutes of Health.

Dr. Kirch previously served as CEO of the Milton S. Hershey Medical Center at The Pennsylvania State University, where he and his leadership team are credited with revitalizing the institution and guiding it through a period of educational innovation and major growth in clinical activity and research funding.

As a psychiatrist and neuroscientist, Dr. Kirch conducted research on the biological basis of and clinical treatments for severe neuropsychiatric disorders. Following the completion of his residency training at the University of Colorado Health Sciences Center, he joined the National Institute of Mental Health in Bethesda, Maryland, where he was named acting scientific director in 1993. His NIMH contributions were recognized when he was presented with the Outstanding Service Medal of the United States Public Health Service.

A prolific writer and public speaker, Dr. Kirch has published more than 150 articles and book chapters, and made numerous presentations to medical, educational, scientific, and advocacy organizations. He currently serves as chair of the Washington Higher Education Secretariat and was elected to the National Academy of Medicine in 2007. In 2014, he was named a Distinguished Life Fellow by the American Psychiatric Association.

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