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Academic Medicine, Vol. 95, No. 10 / October 2020 1515 Perspective The rapid market consolidation of health care delivery systems over the past decade has led to the expansion of many academic medical centers (AMCs) and academic health centers (AHCs) through acquisitions, mergers, and partnerships. 1 Market consolidation has been driven by numerous factors, including health care reform, downward pressure on clinical revenue, increased competition for relatively tight federal research funds, shifts in research foci and sources of funding, a refined understanding of adult learning, regulatory requirements, and institutional priorities regarding productivity. 2 A variety of corporate and affiliation models have evolved to amass multiple hospitals, hospital-based practices, regional medical campuses, and community offices, thus disrupting the 1997 definition from the Association of American Medical Colleges (AAMC) of an AMC as essentially a dyad composed of a medical school (and its faculty) and an integrated “university” hospital (typically with common ownership). 3 The resulting variety of faculty models, employed physicians, and independent physician practices associated with schools of medicine and other health professional schools has created ambiguity in the role of faculty, requiring a more carefully considered definition of what, exactly, is medical school faculty. The diminished opportunity for cross- subsidization of the teaching mission is making it more challenging for faculty to engage in teaching, mentoring, and faculty development. Historically, AMCs and AHCs have used clinical revenue to subsidize the teaching and research missions that rarely cover their costs. As financial margins have tightened, there is now significant scrutiny of how faculty spend their time and an increased focus on engaging in revenue-generating activities. Although there is funding for medical education—through Medicare, Medicaid, and the U.S. Department of Veterans Affairs; tuition dollars from undergraduates; and for public institutions, through state legislatures—the funding does not cover the total cost of education. 4 The economics of medicine is changing the perceptions of faculty roles and priorities, contributing to burnout, and potentially marginalizing medical education. 5 Further, the formation of AMC- and AHC-associated clinically integrated networks that encompass nonteaching clinicians can create tension between medical faculty who have teaching responsibilities and those who do not. Whether one is predominantly a clinician or a scientist, there is a trend toward centralized funds flow models that increasingly rely on individual faculty accountability for productivity. 6 For many clinicians, productivity is measured in relative value units (RVUs). Initially intended as a metric of billing, RVUs have increasingly been used as a surrogate benchmark for comparing clinical services across physicians from similar specialties and disciplines. 7 Because RVUs are measurable, targets can be set for clinicians, driving productivity at the expense of other mission areas, such as education. In 2000, Nutter and colleagues published a report of the Medical Education Panel, 1 of 3 expert panel reports prepared in conjunction with the Mission- Based Management Program of the Abstract As academic medical centers and academic health centers continue to adapt to the changing landscape of medicine in the United States, the definition of what it means to be faculty must evolve as well. Both institutional economic priorities and the need to recalibrate educational programs to address current and future societal and patient needs have brought new complexity to faculty identity, faculty value, and the educational mission. The Council of Faculty and Academic Societies, 1 of 3 membership councils of the Association of American Medical Colleges (AAMC), established working groups in 2014 to provide a strong voice for academic faculty within the AAMC governance and leadership structures. The Faculty Identity and Value Working Group was charged with identifying the attributes and qualities of future academic medicine faculty in light of the transformational changes occurring at many medical schools and teaching hospitals. The working group developed a framework that could be applied throughout the United States by AAMC member schools to define and value teaching activities. This report adds to the work of others by offering a contemporary construct that is flexible and easily adaptable to enable fair and transparent implementation of an education value system; it is especially relevant for systems in which mergers and acquisitions lead to a large number of clinicians. An example of such an implementation at a large and growing academic medical center is provided. The ability to identify and quantify educational effort by faculty could be transformative by highlighting the fundamental importance of faculty to the development of the future medical workforce. The Definition of Faculty Must Evolve: A Call to Action Lisa M. Bellini, MD, Brian Kaplan, MD, Janet E. Fischel, PhD, Carolyn Meltzer, MD, Pamela Peterson, MD, and Roberta E. Sonnino, MD Acad Med. 2020;95:1515–1520. First published online January 14, 2020 doi: 10.1097/ACM.0000000000003158 Please see the end of this article for information about the authors. Correspondence should be addressed to Lisa M. Bellini, Senior Vice Dean for Academic Affairs, 3400 Civic Center Blvd., Bldg. 421, Perelman Center for Advanced Medicine, Philadelphia, PA 19104-5162; telephone: (215) 360-0305; email: lisa.bellini@ pennmedicine.upenn.edu. Copyright © 2020 by the Association of American Medical Colleges