THE RICHARD & HINDA ROSENTHAL LECTURE 2007

Transforming Today’s Health Care Workforce to Meet Tomorrow’s Demands

INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.
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THE RICHARD & HINDA ROSENTHAL LECTURE 2007 Transforming Today’s Health Care Workforce to Meet Tomorrow’s Demands

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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Govern- ing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineer- ing, and the Institute of Medicine. Support for this project was provided by the Richard and Hinda Rosenthal Foundation. International Standard Book Number-13: 978-0-309-11539-1 International Standard Book Number-10: 0-309-11539-6 Copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu. Copyright 2008 by the National Academy of Sciences. All rights reserved. Printed in the United States of America The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin. Suggested citation: Institute of Medicine (IOM). 2008. The Richard and Hinda Rosenthal Lecture 2007: Transforming today’s health care workforce to meet tomorrow’s demands. Washington, DC: The National Academies Press.

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“Knowing is not enough; we must apply. Willing is not enough; we must do.” —Goethe Advising the Nation. Improving Health.

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The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal govern- ment on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding en- gineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engi- neering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sci- ences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal govern- ment. Functioning in accordance with general policies determined by the Acad- emy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering com- munities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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Foreword In 1988, a new outreach program was launched at the Institute of Medicine. Through the generosity of the Richard and Hinda Rosenthal Foundation, a lecture series was established to bring to greater attention some of the critical health policy issues facing our nation today. Each year one or more experts present their views and insights on a major health topic, and the Institute of Medicine later publishes these lectures for the benefit of a wider audience. The Rosenthal Lectures have attracted an enthusiastic following among health policy researchers and decision makers in Washington, D.C., and across the country. The lectures typically engender a lively and productive dialogue. In this volume, we are proud to present the remarks of the 2007 Rosenthal Lecturers—Drs. Kevin Grumbach, Fitzhugh Mullan, and Marla E. Salmon—who spoke on “Transforming Today’s Health Workforce to Meet Tomorrow’s Demands.” I would like to thank Lara Andersen, Clyde Behney, Bethany Hardy, Tracy Harris, Marie Michnich, Adam Rose, Autumn Rose, Sara Sairatupa, Andrea Schultz, Jovett Solomon, and Vilija Teel for ably handling the many details associated with the lecture program and the publication. In their lifetimes, Richard and Hinda Rosenthal accomplished a great deal. The Rosenthal Lectures at the Institute of Medicine are among their enduring legacies, and we are privileged to be the steward of this impor- tant ongoing Series. Harvey V. Fineberg, M.D., Ph.D. President Institute of Medicine 

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Contents WELCOME 1 Harey V. Fineberg, M.D., Ph.D. KEYNOTE PRESENTATIONS: TRANSFORMING TODAY’S HEALTH CARE WORKFORCE TO MEET TOMORROW’S DEMANDS 5 Kein Grumbach, M.D. Professor and Chair Department of Family and Community Medicine University of California, San Francisco 13 Marla E. Salmon, Sc.D., R.N., FAAN Dean and Professor Nell Hodgson Woodruff School of Nursing Director Lillian Carter Center for International Nursing Emory University 24 Fitzhugh Mullan, M.D. Murdock Head Professor of Medicine and Health Policy The George Washington University DISCUSSION 33 BIOSKETCHES 39 ii

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