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A Piece of My Mind
January 9, 2013

Fulfilling Our Leadership Responsibility

Author Affiliations

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Senior Editor.

Author Affiliations: Vanderbilt University Medical Center, Nashville, Tennessee (Drs Gorrindo and Niswender; phillip.gorrindo@vanderbilt.edu); Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts (Dr Tedeschi); and Department of Psychiatry, Yale-New Haven Hospital, New Haven, Connecticut (Dr Powers).

JAMA. 2013;309(2):147-148. doi:10.1001/jama.2012.165720

Academic medical centers (AMCs) enjoy a special position in the ecology of health care in the United States. Their mission statements reflect commitment to understanding mechanisms of disease, discovering novel therapeutic targets, training future clinical leaders, and caring for society's sickest patients. Enjoying this privileged position at the forefront of medicine, however, comes with substantial responsibility. Decisions emanating from AMCs are viewed as “healthy” by the public, given AMCs' leadership role. For this reason, as medical students we were troubled by an inconsistency on our campus: for several years, brand name fast food (BNFF) vendors were prominently located in the hospital. In the classroom, we learned about the impact of lifestyle, environment, and behavioral choices on risk for and development of chronic diseases. We were taught therapeutic strategies (eg, prescribe statins, encourage exercise, and counsel patients to decrease sodium intake) to reduce the burden of cardiovascular and other chronic diseases.