The Social Accountability of Academic Medicine

“Medicine is a social science, and politics is nothing but medicine on a large scale." Rudolf Virchow

Social responsibility in academic medicine is a fundamental concept that defines the ethical and moral obligation of academic health institutions to orient their education, research, and service toward the main health needs of communities and regions, or of nations to those who are mandated to serve. It is not simply a volunteer activity, but an institutional strategy that permeates all its functions.

We can affirm that medicine is a moral commitment, a profession with a series of principles that include respect for others, empathy, compassion, honesty, integrity, altruism, and professional excellence, and these principles constitute the foundations of medical professionalism and the basis of the social contract. As part of this contract, society grants the medical profession certain privileges and resources, justified only to the extent that they are unequivocally placed at the service of the community, and in particular, of those most in need. The public expects both governments and health professions to work to meet the needs for accessible and quality healthcare.  Social responsibility is the tangible expression of this commitment, ensuring that social investment in medical education translates into concrete and measurable improvements in the health of the population.

From a liberal perspective of the 21st century, health (like education and public safety) is considered a social good and a necessity, to a certain degree, in order to have full participation in the activities of society. Since a free society values all members equally and the social participation of all is a prerequisite for social maintenance and progress, society invests generously in health, healthcare, health research, and the education of health professionals.

Hence, institutions that train human talent in health must go beyond traditional technical and academic excellence. Its mission must be redefined to include addressing disparities in health, equity, and access to care, especially for marginalized or under-resourced populations. This implies a constant awareness of academic impacts on society and the strengthening of social structures related to health.

The implementation of social responsibility encompasses the three core functions of academic medicine:

Education: Health curriculums must be adapted to train competent doctors and health professionals who can respond to the priority health needs of their environment. Strengthening the link between medical education and health services is essential to address current and future health needs. Medical education should focus on primary healthcare competencies and integrate digital health. It is necessary to move from a traditional biomedical model to a sustainable care system. Ongoing training and support for health professionals is crucial for the effective delivery of primary healthcare. The health system must prioritize community engagement and preventive strategies to ensure sustainable care.

Research: It must prioritize problems that are relevant to the health of the local and global population. This means directing research efforts toward developing solutions that positively impact health service delivery, prevalent diseases, and health disparities. The results must be accessible and applicable in the real context that needs them most.

Provision of Services: Service activities should function as models of optimal care that respond to community needs, such as collaboration with local health systems, community health promotion, or provision of care in hard-to-reach areas. A classic example is social service programs or university clinics geared toward primary care and the community.

For social responsibility to be effective, it must be measurable and supported by accountable institutional leadership. Simple "social responsibility" (being aware of needs) must evolve into "social commitment" (having an explicit knowledge of needs and the ability to solve them with measurable results).

In essence, social responsibility requires academic medicine to see itself not only as a center of knowledge, but as an agent of social change, fully aligned with the improvement of the health and well-being of the population that its existence confers on it. This approach is crucial to ensure that the medicine of the future is more equitable, fair, and effective for all.