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In this chapter, Dr. Freireich talks about developing and writing a "Flexner Report" for cancer and touring medical centers nationwide. ; https://openworks.mdanderson.org/mchv_interviewchapters/1167/thumbnail.jpg

Ponders on whether Abraham Flexner was responsible for the change in medical education in North America in the early 20th century, owing to his report of 1910. Tries to demonstrate that medical education in the USA was part of a greater whole of major changes at that time. Concludes, though there was a philanthropic influence, Flexner (who refused to accept credit for change) was not the father of the medical reform plan.

The present pattern of medical & legal education can be traced to the movement to raise standards in the first 2 decades of this century. The most influential statement to reform medical education appeared with Abraham Flexner's Carnegie-Foundation sponsored study of medical schools ("Medical Education in the United States and Canada," New York, NY: Carnegie Foundation for the Advancement of Teaching, 1910, Bulletin No. 4). In 19th century America, apprenticeship was the chief preparation for the bar. Proprietary schools offered afternoon classes to non fulltime non law-clerk students who drifted into these schools to gain degrees solely through instruction. Medical education linked with the U's & the medical curriculum was standardized. The establishment of Johns Hopkins Medical School in 1893 provided a model for A. Flexner's view that medicine had become a science. Alfred Z. Reed produced a document ("Raising Standards of Legal Education," American Bar Association Journal, 1921, 7, Nov 21, 571), that surpassed the Flexner report in depth & style. Reed's basic premise was flexibility & reform. Flexner's report received fame while Reed's document remained obscure. Reed's report appeared again in 1921 after a period of reform. Flexner's report has been criticized as an "egocentric view of democracy"; both reports have served to restate the professional education quandary. B. Miller.

The major influences on the thrust of Med educ in the US since the turn of the cent are highlighted by the Flexner Report of 1910 & the Carnegie Report in 1970. Striking changes have occurred-largely through influences external to the Med Sch's-the major one being a vast expansion of bioMed sci & res. The nature of the financing of Med res has emphasized the departmentalization of Med Sch's, making it more difficult to achieve over-all unity & balance. Since WWII there has been a much deeper involvement of the federal & state gov's in the support of Med educ, with emphasis not only on res but on the development of new Sch's-thus creating an increasing dependence of all Med Sch's, both public & private, on gov'al financial support. The alignment & partnership of forces now involved would indicate that the rate of change in Med educ following the current Carnegie Report will be much more rapid than that which was precipitated by the Flexner Report 60 yrs ago. Modified HA.

The major influences on the thrust of medical education in the United States since the turn of the century are highlighted by the Flexner Report of 1910 and the Carnegie Report in 1970. Striking changes have occurred—largely through influences external to the medical schools—the major one being a vast expansion of biomedical science and research. The nature of the financing of medical research has empha sized the departmentalization of medical schools, making it more difficult to achieve over-all unity and balance. Since World War II there has been a much deeper involvement of the federal and state governments in the support of medical educa tion, with emphasis not only on research but on the develop ment of new schools—thus creating an increasing dependence of all medical schools, both public and private, on governmental financial support. The alignment and partnership of forces now involved would indicate that the rate of change in medical education following the current Carnegie Report will be much more rapid than that which was precipitated by the Flexner Report sixty years ago.

У статті розглянуто погляди американського педагога та критика А. Флекснера (1866-1959) щодо реформи медичної освіти США на початку ХХ ст. Зокрема, увагу зосереджено на праці «Медична освіта США та Канади. Доповідь для фонду Карнегі щодо поліпшення викладання» (1910), відомої як «Доповідь Флекснера». У розвідці автор виокремлює передумови реформи та ключові рекомендації А. Флекснера, що стосуються змін у системі американської медичної освіти, а саме: основні завдання, структурні підрозділи, професорсько-викладацький склад, матеріально-технічне забезпечення, методи навчання, організація навчального процесу в медичних школах тощо. ; Until becoming the world leader in medical education, the USA were carrying out various decisive and effective reforms during the 20th century. It is noted that philanthropic organizations and foundations played an important role in the reform of the medical educational paradigm. The outstanding representative of one of these organizations was A. Flexner (1866-1959) - an educator and a critic whose vision of improving medical education became successful and the key one, despite numerous discussions in the academic circles. A. Flexner introduced important recommendations concerning reforming the medical education in his work "Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching" (1910) also known as "Flexner Report". The aim of the paper is to highlight the preconditions of the reform in medical education in the early 20th century, and to point out Flexner's recommendations in the context of the medical educational paradigm. In this paper, the author deals with such methods as general scientific ones (analysis, synthesis, systematization, and generalization) - to provide the holistic view of the content of A. Flexner's ideas concerning the medical education reform in the USA; search-bibliographic method - to study and systematize the scientific and pedagogical literature on the research subject; pedagogical reconstruction- to reproduce historical and pedagogical reality in American medical education in the early 20th century. Thus, there were many factors that caused changes in medical education in the USA. Among them there were social, demographic, economic, political and biological (population health) ones. As for Flexner's recommendations in the context of the medical educational paradigm, they are the main tasks, structural units, faculty, material and technical support, teaching methods, organization of the educational process in medical schools, etc. Besides, A. Flexner proposed to divide the existing medical schools into 3 main categories (A, B, C), and to focus on The Johns Hopkins University School of Medicine. As for the prospects of further research, we are going to describe the influence of Flexner's recommendations on the development of the US medical education in the 20th century.

"Emerging from a study of physician education by the Carnegie Foundation for the Advancement of Teaching, Educating Physicians calls for a major overhaul of the present approach to preparing doctors for their careers. The text addresses key issues for the future of the field and takes a comprehensive look at the most pressing concerns in physician education today. Like the Carnegie Foundation's revolutionizing Flexner Report of 1910, Educating Physicians is destined to change the way administrators and faculty in medical schools and programs prepare their physicians for the future"--Provided by publisher.

Appendix: New education laws (p. 177-230) ; This report embodies a survey of the elementary and secondary schools of the counties, by the General education board. It does not include the schools of Baltimore.--cf. Pref. ; Mode of access: Internet.

Appendix, New education laws: p. 177-230. ; This report embodies a survey of the elementary and secondary schools of the counties, by the General education board. It does not include the schools of Baltimore. cf. Pref. ; Mode of access: Internet.

Committee: Bernard Flexner (chairman) Miss Julia C. Lathrop, William J. Kerby, Walter C. Clephane, William H. Baldwin. ; Issued also with title: Supplement to Annual report of the attorney general of the United States for the year 1914. ; Referred to the Committee on the District of Columbia and ordered printed March 3, 1915. ; Mode of access: Internet.

Cover -- Half Title -- Title Page -- Copyright Page -- Dedication -- Table of Contents -- Preface -- Acknowledgments -- Notes on the text -- List of abbreviations -- Chapter 1: Introduction-culture, capitalism, and communication -- Prologue -- Overview -- Physician culture -- Nursing culture -- Health care organization culture -- Health consumer culture -- Capitalism -- Communication and health care education, empowerment, and outcomes -- Summary -- Bibliography -- Part I: The impact of organizational culture on health care in America -- Chapter 2: Physician culture -- Prologue -- Overview -- Organizing a profession -- Flexner Report -- MD versus DO -- Biomedical model -- Acute/chronic focus -- Physician specialization -- Impact of technology -- Authoritarian role -- Autonomy -- Small business owners and concierge medical practices -- PAs -- PA-C specialization -- Physician culture and U.S. health care -- Summary -- Bibliography -- Chapter 3: Nursing culture -- Overview -- Organizing and nursing culture -- Biopsychosocial model-person focused -- Patient-centered care -- Quality of life focus -- Mid-level providers -- Team member versus subordinate role -- Summary -- Bibliography -- Chapter 4: Health care organization (nonprovider, nongovernment) culture -- Overview -- Organizing health care entities -- From physician-centered to a business model -- Technology and specialization -- Health care education and a team approach -- Marketing and advertising -- Managing care and maximizing return on investment -- Redundancies and competition -- Retail pharmacies -- Quality and risk management -- Mental health care -- Summary -- Bibliography -- Chapter 5: Health consumer culture -- Overview -- Health consumers as organizational perspective -- Socialization -- The great unknown -- Passive consumers -- Power and control -- Acute care/disease focus.

Cover -- Title -- Copyright -- Contents -- Foreword to the Second Edition -- Foreword to the First Edition -- References -- A Note From the Author -- How To Use This Text: A Note to Faculty -- Note -- References -- Acknowledgments -- Section I: The Context of Health Care and Health Care Reform -- Chapter 1: What Is Health Economics and Why Is It Important to Nurses? -- Theoretical Economic Approaches -- Social Determinants of Health -- How Economics Differs from Financing and Reimbursement -- Note -- References -- Chapter 2: A Story of Unintended Consequences: How Economic and Policy Solutions Create New Challenges -- The Influence of the Flexner Report -- Early Hospitals -- Social Reform Addressing Unintended Consequences Of Employer-Based Insurance -- Attempts to Change Financial Incentives to Contain Costs -- The Affordable Care Act and New (and Renewed) Payment Models -- COVID-19 -- Note -- References -- Chapter 3: The Patient Protection and Affordable Care Act of 2010 -- The Patient Protection and Affordable Care Act of 2010 -- Insurance Access-Employer Mandates and Medicaid Expansion -- Insurance Access- Expanded Eligibility -- What About Those Who Are Still Not Covered By One of These Mechanisms? -- What Does the Health Care Exchange Do? -- Where Can a Nurse Direct a Patient Who Asks Questions About How to Navigate the Complex Terrain of Health Insurance? -- Insurance Lessons from Covid-19 -- Acknowledgment -- References -- Chapter 4: Payment Reform -- From Volume to Value: Payment Models that Move Away from Fee-for-Service Reimbursement -- Nursing Roles Within Emerging Payment Models -- Note -- References -- Section II: Health Care Economics: An Overview -- Chapter 5: How Health Care Markets Differ From Classic Markets -- What Does it Mean to Bear the Consequences of Financial Decision-Making?.

BACKGROUND: Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005-2008) strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. MAIN TEXT: The challenges faced by LMICs include rapid urbanization, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs). CONCLUSION: SPHs in LMICs can contribute to overcoming several public health challenges being faced by LMICs, including achieving SDGs. Most importantly they can develop cadres of competent and well-motivated public health professionals: educators, ...