Has traditional medicine had its day? The need to redefine academic medicine

Abstract

The field of medicine has traditionally focused on care for individual patients, with emphasis on disease treatment and less focus on disease deterrence and the socioeconomic and behavioural factors that impact health and wellbeing. Over the years, this model has served patient care well. However, the most pressing issues facing health and health care today—including non-communicable diseases (NCDs), an ageing global population, and complex, systemic barriers to health equity—are not easily solved with an individual patient approach. Infectious diseases outbreaks such as COVID-19 present similar challenges, in that effective response and preparedness all require population-level management in addition to direct clinical care. This combination of strategies is made difficult by the continued fragmentation of the traditional medical system and a lack of a strong relationship with community public health infrastructure. The practice of traditional medicine is rooted in the bench-to-bedside model of academic medicine that is responsible for today's education, research, and approach to medical care. To meet current needs of health and health care, medicine will require more health workers who are community and population health oriented and digitally competent; whose work integrates social, behavioural, data, and other sciences; and who are socially responsible. To modernise traditional medicine to be fit for today's purpose will require a re-examination of the current approach of academic medicine. Currently, the field of academic medicine integrates clinical and academic partners within Academic Health Science Centers (AHSCs), physical campus settings that house scientific research, medical training, and direct patient care.1Delaney B Moxham J Lechler R Academic health sciences centres: an opportunity to improve services, teaching, and research.Br J Gen Pract. 2010; 60: 719-720Crossref PubMed Scopus (11) Google Scholar AHSCs have broad resources, capabilities, and human capital. They are crucial assets for those they serve but have not historically extended their reach beyond their immediate patient and participant populations. In this way, they are often viewed as ivory towers: centres of academia lacking substantial engagement with the communities they inhabit. In contrast, primary prevention is more often the pursuit of national, state, and local public health systems. Public health systems work in the community but are typically under-resourced, face pronounced staff shortages, and lack a strong data infrastructure. The large burdens of COVID-19, NCDs, and inequity across the globe cannot be addressed within the current medical system. To meet the challenges of our time, traditional medicine must improve communication and engagement with the community and increase collaboration and integration with public health. Calls for this type of integration have been increasing for the past decade. In 2010, the US Government commissioned the Institute of Medicine (IOM; now known as the National Academy of Medicine), to study how the government could work to improve population health through the integration of primary care and public health. The resulting report,2Institute of MedicinePrimary care and public health: exploring integration to improve population health. National Academies Press, Washington, DC2012Google Scholar published in 2012, emphasised the impact of social, behavioural, and environmental factors on health outcomes. The IOM noted that, in the USA, the health-care system's unbalanced funding structure allocates substantially greater financial resources towards treating illness than it does towards prevention, leaving the country inadequately equipped to address challenges of health promotion.2Institute of MedicinePrimary care and public health: exploring integration to improve population health. National Academies Press, Washington, DC2012Google Scholar The emerging concept of population health, as defined by the IOM in 2013, calls for the convergence of health care, community, and public health to improve the health outcomes of the population.3Institute of MedicineToward quality measures for population health and the leading health indicators. National Academies Press, Washington, DC2013Google Scholar Since the commission of the IOM study in 2010, implementation of the US Patient Protection and Affordable Care Act has expanded access to preventive services, provided dedicated funding for public health, and created opportunities for collaboration between community health departments, primary care, and hospitals in the USA. The act also authorised the implementation of Accountable Care Organizations, which seek to better align financial incentives for payers and providers, with goals of reducing health-care costs, improving patient experience, and improving outcomes (ie, the triple aim).4Berwick DM Nolan TW Whittington J The triple aim: care, health, and cost.Health Aff (Millwood). 2008; 27: 759-769Crossref PubMed Scopus (3313) Google Scholar However, despite these encouraging developments, the USA continues to struggle with aligning public health and health-care delivery. This lack of coordination was starkly illustrated during the early days of the COVID-19 pandemic. Within the USA, state public health departments were forced to rely on underfunded, out-of-date surveillance and tracking systems, which led to delays in reporting local, state, and national COVID-19 rates. These problems were exacerbated by difficulties in communication between testing centres, laboratories, and public health departments. Ultimately, this led to major failures in early intervention and containment.5Banco E Inside America's Covid-reporting breakdown.https://www.politico.com/news/2021/08/15/inside-americas-covid-data-gap-502565Date: 2021Date accessed: August 11, 2022Google Scholar Several recent reports suggest that health-care fragmentation at a variety of levels—local, state, and federal—resulted in missed opportunities to improve patient care, expand disease surveillance and case reporting, promote vaccination, and improve pandemic-related communications.6Veenema TG Toner E Waldhorn R et al.Integrating primary care and public health to save lives and improve practice during public health crises: lessons from COVID-19. The Johns Hopkins Center for Health Security, Baltimore, MD2021Google Scholar, 7Commonwealth Fund Commission on a National Public Health SystemMeeting America's public health challenge: recommendations for building a national public health system that addresses ongoing and future health crises, advances equity, and earns trust. Commonwealth Fund, New York, NY2022Google Scholar The need to reduce fragmentation and improve integration of public health and health-care delivery is not unique to any one country. Similar to the USA, calls for better integration have been seen internationally for many years.8Rechel B How to enhance the integration of primary care and public health? Approaches, facilitating factors and policy options. European Observatory on Health Systems and Policies, Copenhagen2020Google Scholar, 9Tham TY Tran TL Prueksaritanond S Isidro JS Setia S Welluppillai V Integrated health care systems in Asia: an urgent necessity.Clin Interv Aging. 2018; 13: 2527-2538Crossref PubMed Scopus (24) Google Scholar, 10Acosta Ramírez N Giovanella L Vega Romero R et al.Mapping primary health care renewal in South America.Fam Pract. 2016; 33: 261-267Crossref PubMed Scopus (12) Google Scholar, 11Azevedo MJ The state of health system(s) in Africa: challenges and opportunities. Springer International Publishing, Cham, Switzerland2017Google Scholar It is also true that major gaps in integration were uncovered worldwide during the pandemic. Poor collaboration and resource utilisation and fragmentation hampered pandemic response from Europe to Asia.12Park S Elliott J Berlin A Hamer-Hunt J Haines A Strengthening the UK primary care response to COVID-19.BMJ. 2020; 370m3691PubMed Google Scholar, 13Noknoy S Kassai R Sharma N Nicodemus L Canhota C Goodyear-Smith F Integrating public health and primary care: the response of six Asia-Pacific countries to the COVID-19 pandemic.Br J Gen Pract. 2021; 71: 326-329Crossref PubMed Scopus (3) Google Scholar In England, support for the system of communicable disease control has weakened over time. During the pandemic, this resulted in the need for private outsourcing of COVID-19 testing and tracking programmes, which subsequently led to challenges in communication with local health departments, difficulties ensuring comprehensive community contact tracing, and delays in linking test results to National Health Service records.14Roderick P Macfarlane A Pollock AM Getting back on track: control of COVID-19 outbreaks in the community.BMJ. 2020; 369m2484PubMed Google Scholar, 15Torjesen I Covid-19: local public health teams being denied access to data that could help them trace cases.BMJ. 2020; 370m2883Google Scholar Challenges for many countries were exacerbated by pre-existing workforce shortages and inadequate health system infrastructure.16Unruh L Allin S Marchildon G et al.A comparison of 2020 health policy responses to the COVID-19 pandemic in Canada, Ireland, the United Kingdom and the United States of America.Health Policy. 2022; 126: 427-437Crossref PubMed Scopus (14) Google Scholar WHO has stressed the need to use the dramatic impact of the pandemic as a catalyst for change within our global health system to improve investment in health, strengthen international preparedness, and recognise the impacts of social determinants of health.17Ghebreyesus TA WHO chief: COVID-19 needs to be a turning point. Financial Times.https://www.ft.com/content/4dcf31d4-5874-4a8b-9342-60a980dfaf5dDate: 2020Date accessed: July 21, 2022Google Scholar Indeed, we must take the lessons learned from the COVID-19 pandemic to push for the integration we have known is necessary for many years. Because today's practice of medicine is built on the foundation of academic medicine, transforming medicine will first require a redefinition of academic medicine. Almost 10 years before the first case of COVID-19, my colleagues and I called for a shift in the traditional system of academic medicine. In 2010, we published a paper in The Lancet proposing an evolution from bench-to-bedside to a “bench to bedside to population” model, which would encompass the entirety of the discovery to care continuum.18Dzau VJ Ackerly DC Sutton-Wallace P et al.The role of academic health science systems in the transformation of medicine.Lancet. 2010; 375: 949-953Summary Full Text Full Text PDF PubMed Scopus (102) Google Scholar We viewed this as an approach to closing the gaps in traditional medicine and increasing integration from research to care to population: first, minimising the gap between scientific discovery and clinical translation (bench-to-bedside); and second, closing the gap between clinical best practices and community dissemination and adoption (bedside-to-population). In this structure, the AHSC would act as a systems integrator to provide cohesive care across settings and populations and facilitate a pathway from basic to translation research, progression to direct care delivery, and finally, movement towards global and population health. A decade has passed since we published our initial manuscript. Considering the growing recognition of the importance of primary prevention and the impact of NCDs, compounded by the global impacts of the COVID-19 pandemic, and the contribution of social and health equity, we recently published an updated version of our model.19Dzau VJ Balatbat CA Ellaissi WF Revisiting academic health sciences systems a decade later: discovery to health to population to society.Lancet. 2021; 398: 2300-2304Summary Full Text Full Text PDF PubMed Scopus (8) Google Scholar Our revised “bench to bedside to population to society” approach is intended to reflect a need for convergence of care delivery with public health, as well as the importance of data science, the substantial contributions of social determinants of health, and the impact of health and social inequities (figure).19Dzau VJ Balatbat CA Ellaissi WF Revisiting academic health sciences systems a decade later: discovery to health to population to society.Lancet. 2021; 398: 2300-2304Summary Full Text Full Text PDF PubMed Scopus (8) Google Scholar In a bench-to-society system, academic medicine would continue to lead in discovery science, translation, and delivery of high-quality care, but also extend its mission to address social determinants, ethics, and equity. Globally, there is increasing recognition of the need to integrate social and behavioural perspectives into our work, to foster community partnerships, and to build on these advances to benefit population outcomes. Societal issues are intertwined with the wellbeing and health of the population. Academic medicine must work to drive social change and advance policy, social cohesion, and trust. It is our belief that this reshaping of academic medicine will form the foundation for producing the next generations of health workers, providing them with the knowledge and technology that will improve population health. The 2021 model19Dzau VJ Balatbat CA Ellaissi WF Revisiting academic health sciences systems a decade later: discovery to health to population to society.Lancet. 2021; 398: 2300-2304Summary Full Text Full Text PDF PubMed Scopus (8) Google Scholar emphasised several new areas: convergence science and practice to population health; data science and digital technology; community engagement and equity, with a commitment to social responsibility and the greater good; and development of the future workforce. In a bench-to-society model, academic medicine must broaden its scope and move beyond interdisciplinary science to true convergence science and practice. Although interdisciplinary or team science emphasise research collaboration, convergence science seeks to integrate a broad variety of disciplines and technologies beyond the traditional life sciences, to include many branches of physical, quantitative, and social sciences, as well as unique disciplines including behavioural economics, law, ethics, and engineering. Convergence creates systems approaches that seek to solve the most vexing health and scientific challenges. In describing the convergence revolution, Sharp and colleagues20Sharp P Jacks T Hockfield S Convergence: the future of health. Massachusetts Institute of Technology, Cambridge, MA2016Google Scholar note that convergence science is necessary to bring about breakthroughs in prevention, early diagnosis, and innovative treatment for the complex, chronic NCDs that are a growing burden to health-care systems globally. COVID-19 has underscored why convergence is needed to address the existential health threats of our time. Although the pandemic has affected individuals and families throughout the globe, we have also observed differential risks of exposure, susceptibility, and consequences of the disease. For example, crowded housing, poor workplace protection, reliance on public transportation, and lack of insurance or underinsurance all contribute to disease risk and cause heightened vulnerability to disease in low-income or otherwise marginalised populations.21Burström B Tao W Social determinants of health and inequalities in COVID-19.Eur J Public Health. 2020; 30: 617-618Crossref PubMed Scopus (122) Google Scholar Likewise, supply chain barriers, legal and regulatory implications, and intellectual property considerations impact global COVID-19 testing, treatment, and vaccine inequities.22Asundi A O'Leary C Bhadelia N Global COVID-19 vaccine inequity: the scope, the impact, and the challenges.Cell Host Microbe. 2021; 29: 1036-1039Summary Full Text Full Text PDF PubMed Scopus (35) Google Scholar It is not enough, therefore, to focus on advancing scientific achievements to combat the impact of the pandemic—we must also incorporate social, behavioural, economic, legal, and policy considerations into our research and practice. We have written previously on the need to reimagine population health in terms of convergence, using the collective participation of stakeholders from across fields to bring together scientific research, policy, and implementation practices to improve health care and health outcomes.23Dzau VJ Balatbat CA Reimagining population health as convergence science.Lancet. 2018; 392: 367-368Summary Full Text Full Text PDF PubMed Scopus (8) Google Scholar For academic medicine, embracing convergence science and practice will require new strategies and partnerships, although there is little guidance available on how best to establish effective convergence science programmes. The US National Academy of Medicine has called previously for a national vision-setting body to build awareness and guide convergence evolution.24National Research CouncilConvergence: facilitating transdisciplinary integration of life sciences, physical sciences, engineering, and beyond. National Academies Press, Washington, DC2014Google Scholar Leaders in academic medicine can also work to develop policies to support convergence research and seek to partner with stakeholders internal to their universities (eg, schools of law, engineering, or policy) as well as external community organisations. AHSCs must develop their own internal core capabilities and expertise in areas such as population health, data science, and behavioural and social sciences. The past decade has seen massive growth in the amount of health-related data available, including data collected at the point of care; within research settings; and across domains in which people live, work, and play. The rise of data is notable not only for the sheer volume, but also for the complexity, diversity, and speed at which they are being collected. In a recent perspective piece on aligning mission with digital health strategy within AHSCs, Cohen and colleagues25Cohen AB Stump L Krumholz HM et al.Aligning mission to digital health strategy in academic medical centers.NPJ Digit Med. 2022; 5: 67Crossref PubMed Scopus (1) Google Scholar note that a “broad digital health realignment” is necessary for AHSCs to continue to accomplish mission-oriented goals of optimal clinical care and patient experience, as well as high-level research, education, and training. There is great opportunity for AHSCs to lead the way in the adoption of a digital health approach that aligns primary and tertiary care, research, and public health. When aggregated and analysed, data integration holds promise for understanding health and disease and yielding new treatments and therapies—for example, advancing drug and treatment discoveries. A key example highlighting the value of data integration—linking health-care delivery and research—is the UK Randomized Evaluation of Covid-19 Therapy (RECOVERY) trial,26Mullard A RECOVERY 1 year on: a rare success in the COVID-19 clinical trial landscape.Nat Rev Drug Discov. 2021; 20: 336-337Crossref PubMed Scopus (8) Google Scholar which sought to test possible treatment options among patients hospitalised with COVID-19. RECOVERY leveraged built-in data linkages within the National Health Service system to create a streamlined mega-trial, able to enrol a large number of patients with minimal burden to providers. The RECOVERY trial has now shown the benefits of potential COVID-19 treatments such as dexamethasone and tocilizumab, as well as the lack of benefits of other proposed treatments, including azithromycin and hydroxychloroquine. Building on such mega-trials with the incorporation of broad types of public and digital health data will allow for a more complex, layered understanding with regard to how patient environment impacts care delivery and treatment. Traditionally, point-of-care data have not been linked to broad public and community health data, which are better able to capture nuance within physical and social environments, as well as social determinants of health and intersectional impact of demographic factors such as race, ethnicity, age, sex, gender, and education. Medicine, therefore, must invest in and embrace data and quantitative science and engage in digital health technology innovation by creating the infrastructure to capture, standardise, and harmonise point-of-care data with community health data. To achieve sustainable integration, AHSCs should commit to data sharing and health information exchange and collect socioeconomic data, genomic information, and other types of broad datasets. These data can be leveraged to develop hypotheses, generate evidence, drive decision support, and provide algorithms for problem solving and automation via artificial intelligence and machine learning. In considering how to improve data integration, the Council of State and Territorial Epidemiologists in the USA provided five key recommendations.27Hagan CN Holubowich EJ Criss T Driving public health in the fast lane: the urgent need for a 21st century data superhighway. Council for State and Territorial Epidemiologists, Atlanta, GA2019Google Scholar First, there is an urgent need for health systems to adopt an enterprise approach to modernisation by using common core infrastructure, which will require new and sustained funding opportunities to support its development. Second, data systems must be interoperable and able to easily communicate across settings. Third, patient privacy and data security must be protected. Fourth, the workforce must be capable of using the data infrastructure effectively. Finally, the health-care system should seek to pursue strong public–private partnerships to leverage the private sector's long-term experience in data tracking, analytics, and innovation. Thus far, efforts to update public health data and surveillance systems have largely been inequitable, leaving some communities thriving and others facing insurmountable challenges. Integration efforts face substantial challenges across the globe. In the EU, discrepancies in digital skills are such that if advances in digital health were to be implemented on a systemic level, only certain population groups (eg, those who are younger and more highly educated) would be able to benefit from these changes.28Wong BLH Maaß L Vodden A et al.The dawn of digital public health in Europe: implications for public health policy and practice.Lancet Reg Health Eur. 2022; 14100316Google Scholar Therefore, restructuring and integrating data infrastructure must be approached with equity in mind to avoid deepening existing disparities.29van Kessel R Hrzic R O'Nuallain E et al.Digital health paradox: international policy perspectives to address increased health inequalities for people living with disabilities.J Med Internet Res. 2022; 24e33819Crossref PubMed Scopus (12) Google Scholar There has long been an understanding that health care itself contributes to a small proportion of health outcomes, combined with an increasing recognition of the outsized impact of social determinants of health, such as housing, income, and education. In 2008, WHO declared social justice a matter of life and death.30Marmot M Friel S Bell R Houweling TA Taylor S Closing the gap in a generation: health equity through action on the social determinants of health.Lancet. 2008; 372: 1661-1669Summary Full Text Full Text PDF PubMed Scopus (2081) Google Scholar COVID-19 has shown that social inequities can rival biological inequities with regard to disease risk, exposure, and outcomes. It is clear that COVID-19, as well as other major health threats, must be viewed through an intersectional equity lens if we hope to develop ethically just treatments and interventions.31Ismail SJ Tunis MC Zhao L Quach C Navigating inequities: a roadmap out of the pandemic.BMJ Glob Health. 2021; 6e004087Crossref Scopus (20) Google Scholar Health inequalities are largely preventable and must be addressed by taking action on all social determinants of health via a proportionate, universal approach addressing the social gradient of health inequities.32Marmot M Bell R Fair society, healthy lives.Public Health. 2012; 126: S4-10Crossref PubMed Scopus (421) Google Scholar, 33Marmot M Health equity in England: the Marmot review 10 years on.BMJ. 2020; 368: m693Crossref PubMed Scopus (183) Google Scholar To target long-standing disparities, medicine must consider social determinants in caring for and managing patients, address the upstream determinants of health and equity, and recognise the importance of the inter-relationship between health and society. It is our belief that there can be no health equity unless there is social equity. To accomplish these goals, AHSCs must work with community organisations and sectors to address social issues including housing, job creation, food security, education, career development, and more. Additionally, they must leverage their role as anchor institutions—that is, as major employers and economic drivers within their locality—to do social good by investing in regional development and equity. Wilkins and Alberti34Wilkins CH Alberti PM Shifting academic health centers from a culture of community service to community engagement and integration.Acad Med. 2019; 94: 763-767Crossref PubMed Scopus (25) Google Scholar note that, although AHSCs have a strong history of service, there is a need for an “enterprise-wide approach to community engagement” that requires not only seeing communities as groups of individuals in need of service or care, but as true partners and collaborators in improving local health and health care. In this manner, AHSCs can work to both advance solutions and health policy while promoting social equity, cohesion, and trust. A prime example of AHSCs and other care-delivery organisations seeking to improve community health and equity can be seen in the Accountable Health Communities (AHC) model in the USA. The AHC approach seeks to incentivise health-care organisations to assess social determinants of health and connect patients to community resources to determine whether a more integrated approach to care provision might improve health outcomes and reduce costs.35RTI InternationalAccountable Health Communities (AHC) model evaluation: first evaluation report. RTI International, Research Triangle Park, NC2020Google Scholar Although evaluation is still in progress, early analysis suggests this type of intervention has led to initial decreases in emergency department visits. AHCs and similar models represent an important step towards integrating traditional care delivery and public health, via partnership with payers and relevant community stakeholders. Academic medicine must also look internally at their own structures and operations. AHSCs must be mission-oriented and values-oriented, with a commitment to equity in everything they do, and a goal to address root causes, such as structural racism, within academic medicine and across society itself. Diversity, equity, and inclusion in health care, education, research, and the workforce must be prioritised. Finally, academic medicine must play a leading part in addressing some of the most complex, existential threats facing society and ensure that equity is at the centre of their response. For example, AHSCs must treat climate change and environmental justice as public health and equity crises, and work actively to communicate, educate, investigate, and develop solutions. They must work to mitigate risks and societal implications of transformative science and technology, and tackle misinformation and gain public trust. Achieving the goals outlined in this Lecture will require a workforce that is trained beyond the approach of traditional medicine. AHSCs will be required to educate a new type of clinician that is community-oriented and socially connected. In this vein, Bibbins-Domingo and Fernandez36Bibbins-Domingo K Fernandez A Physician–public health practitioners—the missing academic medicine career track.JAMA Health Forum. 2022; 3e220949Crossref PubMed Google Scholar recently proposed the physician–public health practitioner model. Trainees would be taught not only to provide direct care, but to provide scientific and medical leadership within a collective impact model; communicate scientific research and provide technical assistance to community partners; provide guidance in programme development and evaluation; and disseminate best clinical and scientific practices. To provide this type of community-oriented education, AHSCs will need to work with partners to develop new curricula and competencies in team science and interprofessional education, social inequities and ethics, and quantitative sciences. Additionally, AHSCs must seek to expand and diversify their workforces to reflect the communities and patient populations they serve. Trainees will need to gain early exposure and direct experience in community and social issues in their preclinical years. This will require expanded funding for training and the potential deployment of economic incentives to encourage young practitioners to practice in rural or otherwise underserved areas.37National Academies of Sciences, Engineering, and MedicineImplementing high-quality primary care: rebuilding the foundation of health care. National Academies Press, Washington, DC2021Google Scholar Evolving and expanding training opportunities for the public health workforce must also be considered. COVID-19 has shown the need for strengthened digital public health and surveillance strategies to achieve disease prevention and universal care goals.28Wong BLH Maaß L Vodden A et al.The dawn of digital public health in Europe: implications for public health policy and practice.Lancet Reg Health Eur. 2022; 14100316Google Scholar WHO's global strategy on digital health suggests that building digital health infrastructure offers an opportunity to dramatically improve global health prevention and outcomes.38WHOGlobal strategy on digital health 2020–2025. World Health Organziation, Geneva, Switzerland2021Google Scholar In pursuit of this goal, AHSCs and public health departments can partner in training the public health workforce to develop and embrace digital health technology. The pandemic has provided welcome examples of what these partnerships might look like. For example, California's Virtual Training Academy, implemented by subject matter experts from two universities, in partnership with the state public health system, was an early pandemic endeavour to build a skilled workforce of contact tracers and case investigators state-wide. Over 10 000 enrolees completed training in a period stretching slightly over a year, with trainees reporting significant improvement in knowledge assessments and self-perceived skills.39Golston O Prelip M Brickley DB et al.Establishment and evaluation of a large contact-tracing and case investigation virtual training academy.Am J Public Health. 2021; 111: 1934-1938Crossref PubMed Scopus (4) Google Scholar It will also be important to combat shortages in the workforce. By 2030, the global public health workforce is expected to face a shortage of 15 million workers.40Liu JX Goryakin Y Maeda A Bruckner T Scheffler R Global health workforce labor market projections for 2030.Hum Resour Health. 2017; 15: 11Crossref PubMed Scopus (155) Google Scholar The remaining workforce frequently lacks relevant formal training and does not reflect the populations it serves. Additionally, the public health workforce is older, with a substantial portion set to age out within the coming years.2Institute of MedicinePrimary care and public health: exploring integration to improve population health. National Academies Press, Washington, DC2012Google Scholar Similar strategies should be used to rebuild the public health workforce—sharing resources and engaging partners; investing in employees; promoting diversity, equity, and inclusion; and cultivating strong leaders. There is also a need for a broad reassessment of capabilities, roles, and competencies and a true overhaul of the workforce recruitment process.41Kumar P Lurie E Parthasarathy R Building the US public-health workforce of our future.https://www.mckinsey.com/industries/public-and-social-sector/our-insights/building-the-us-public-health-workforce-of-the-futureDate: 2022Date accessed: August 11, 2022Google Scholar The title of this paper asks the question, has traditional medicine had its day? The answer is a strong no. Over the years, the medical model has served patients well. Our society needs the dedicated practitioners of medicine to provide direct compassionate patient care and retain the important attributes of traditional medicine. However, to address the increasing challenges in health in the current era, traditional medicine must evolve to meet the demands of our time. Medicine must extend from the traditional individual patient-disease focus to promote prevention and alignment with public health and social needs. The foundation of traditional medicine is rooted in the education, research, and practice of academic medicine. To change traditional medicine, it is necessary to redefine academic medicine. Over the past decade, academic medicine has faced rapid, dramatic changes, including the impact of a global pandemic. Given the complex, systematic challenges facing global health care today, there is a need to transition away from the bench-to-bedside model to an approach that more accurately reflects the need for attention to social determinants of health, healthy equity, and broad population-level needs: the bench-to-bedside-to-population-to-society model.