Urban Medical Centers: Balancing Academic and Patient Care Functions

Urban Medical Centers: Balancing Academic and Patient Care Functions

Urban Medical Centers: Balancing Academic and Patient Care Functions

Urban Medical Centers: Balancing Academic and Patient Care Functions


"Urban Medical Centers: Balancing Academic and Patient Care Functions addresses the profound and urgent effects of the stresses and strains in the U. S. health care system on urban academic health centers. It also assesses the diversity of responses these centers are mounting to ensure not only survival but, more importantly, a position from which they can continue to make significant contributions to the advancement of American medicine. In this report of the proceedings of the Tenth Annual Health Policy Conference (1995), sponsored by Cornell University Medical College, nine leaders of medical education describe the approaches that their respective institutions are exploring and, in some cases, have begun to implement. Public and private medical centers - large and small, research- and service-oriented, located in various regions of the countryare represented. The provocative discussions between the presenters and a panel of senior medical facultyadministrators, representatives of the health insurance sector, and health foundation executives - are summarized in a concluding chapter." Title Summary field provided by Blackwell North America, Inc. All Rights Reserved


Eli Ginzberg

In planning this year's Cornell University Medical College health policy conference, Dr. David Rogers and I almost instinctively chose as the theme, the future of urban academic medical centers. Although it had been the subject of the previous year's conference, the profound and urgent impacts on urban academic health centers (AHCs) of stresses and strains in the U.S. health care system left no alternative but to revisit the subject and open up some new lines of inquiry. Specifically these related to the challenges to academic and patient care functions posed by structural changes, altered financing systems, declining clinical income, and uncertain funding for medical education and research.

The chapters that follow comprise the presentations by several distinguished leaders of academic health centers and a chapter entitled "Perspectives," in which I have reflected on the interaction between the presenters and the various participants in the conference sessions. Among the latter were several urban medical school faculty members with administrative responsibilities; representatives of the health insurance sector; and selected health foundation executives. the title, "Perspectives," rather than the more usual "Summary," suggests the difficulty I had in identifying a distinct set of conclusions to which the thirty-odd participants would subscribe.

The designation "Perspectives" underscores my conviction -- which I believe was shared by most of the participants -- that given the scale and scope of the changes affecting the urban AHCs and the diversity of the responses they are mounting to the threats and opportunities confronting them now and in the future, it would be misleading to interpret their current efforts as other than exploratory forays in the search for new and winning strategies. the directions they will take are just coming into view and their testing and refinement will preempt the best efforts of the AHCs for some years to come.

In short, this volume does not presume to be anything more than a report, as of early 1995, of the different ways in which various urban AHCs are seeking to reposition themselves in order to protect and ad-

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