The Pyramid Model

Our Pyramid Model of Academic Medicine

To understand the need for the Pyramid, first you have to understand the significance of the triangle. This isn’t Geometry 101, and it’s not something cryptic out of a Dan Brown novel. It’s a whole new way to think about academic medicine.

New problems deserve creative thinking and different solutions. When questions change, the same old answers don’t work so well. The basic medicine of academic medicine, developed at Johns Hopkins Hospital more than a century ago, is represented by a triangle showing a triple set of priorities: Teaching, Patient Care, and Research.

But medicine today is very different from medicine as it was practiced and taught 100 years ago. Five years ago, David Hellmann concluded that the triangle model lacks several key features — beginning with a focus. “We needed to have an epicenter, a single priority instead of three separate missions,” he says. So he added a new dimension to the model — making it a pyramid, with all sides pointing toward the patient.

In the Pyramid model, public trust is foremost, and the pinnacle is occupied by the patient, family, and community. Says Hellmann: “Putting them at the pinnacle emphasizes that everything we do must benefit the patient and society. The primacy of the patient needs to be explicit in every aspect of our work.”

Also important in the Pyramid: Collaboration. Instead of promoting collaboration, the old model tends to spawn jealously guarded academic fiefdoms and turf battles, and scientists who sometimes lose sight of the bigger picture, and of what should be their goal. At the CIM, we believe that the answers to the health problems we’re facing today can only be achieved by teamwork. Our Pyramid has a base, too, and it’s made up of our whole work force.