title: The future of academic medical centers in the United States: passing through the valley of the shadow of death.
abstract: The last 2 decades witnessed remarkable events in the life of academic medical centers (AMCs) in the United States. Twenty years ago, AMCs were thriving as the era of fee-for-service medicine came to a close: clinical departments were expanding, hiring new faculty members, purchasing new equipment as necessary, and funding research projects and protected research time with the abundant clinical revenues. The subsequent 20 years since that golden era came to a close witnessed teh disappearance of these expansionary trends. Departments have contracted, protected research time and start-up funds have declined precipitously, and many faculty members are infected with a sense of malaise and fear for the future.
authors.affiliation: Department of Medicine, University of Arizona Health Sciences Center, Tucson, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Alpert
authors.forename: D M
authors.initials: DM
authors.lastname: Flanagan
authors.forename: N A
authors.initials: NA
authors.lastname: Botsford
mesh_terms: D000046:Academic Medical Centers / Q000191:economics / Q000458:organization & administration / Q000639:trends*; D005180:Faculty, Medical; D005544:Forecasting; D006801:Humans; D008329:Managed Care Programs / Q000639:trends; D012456:Salaries and Fringe Benefits; D014481:United States