Collaborative care: A new model for a new century

From the imagined vantage point of the year 2020, the author recounts the p roblems and deficiencies of health care in the 1990s and describes how acad emic medicine's leaders successfully confronted them. A key part of their s trategy was to work together to form a coordinated network of medical schoo ls, teaching hospitals, and academically oriented health systems, along wit h their staffs and a variety of community-based partners. In this way, they set a national agenda, pursued common goals, freely shared information and best practices, and cooperated to optimize their effectiveness in educatio n, research, and clinical care. A major outcome of this new network was the Collaborative Care model of hea lth care, based on the premise that a basic purpose of the health care syst em is to achieve measurable improvements in the health of individuals and c ommunities in ways that are cost-conscious, quality-driven, evidence-based, and patient-, family-, and community oriented. Academic institutions forme d strong partnerships with many stakeholders (e.g., purchasers of health ca re services) to make the Collaborative Care approach work. In addition, the re were several other important keys to Collaborative Care's success, such as the full integration of clinical research with; clinical care and the re storation of trust in the health care enterprise. The author returns to rea lity and the 1990s. He challenges academic medicine to pursue the Collabora tive Care vision, saying that "we should not accept without challenge what we know to be abominable just because it appears to be inevitable.... Our c hoice is to continue to struggle for survival as the environment around us gets harsher and harsher... or to fix the environment" using the power of c ollaboration to unleash academic medicine's unlimited creativity and wisdom .