title: Academic psychiatry and health care reform: strategic initiatives for sustaining the clinical mission.
abstract: Health care reform has posed special challenges for departments of psychiatry in academic medical centers. This report describes one department's strategic responses to a marketplace with high penetration by managed care and provides examples of the kinds of faculty concerns that can arise when major departmental reorganizations are attempted. The department's successful adaptation to a radically altered professional environment is attributed to the following five initiatives: vertical integration and diversification of clinical programs, service line management, outcomes measurement, regional network development, and institutional managed care partnerships Although the authors did not design their adaptive efforts as a research study, they offer objective data to support their conclusion that the viability of their overall clinical enterprise has been sustained despite an external environment inhospitable to academic psychiatry.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA. lmccabe@jhmi.edu
authors.forename: O Lee
authors.initials: OL
authors.lastname: McCabe
authors.forename: Howard S
authors.initials: HS
authors.lastname: Gwon
authors.forename: Paul R
authors.initials: PR
authors.lastname: McHugh
authors.forename: William R
authors.initials: WR
authors.lastname: Breakey
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Schwartz
authors.forename: Michael R
authors.initials: MR
authors.lastname: Clark
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kaminsky
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D018166:Health Care Reform; D006754:Hospital Restructuring; D006801:Humans; D008329:Managed Care Programs; D009935:Organizational Affiliation; D009936:Organizational Innovation; D011567:Psychiatric Department, Hospital / Q000458:organization & administration*; D011570:Psychiatry / Q000193:education* / Q000458:organization & administration*; D013663:Teaching / Q000379:methods; D014481:United States