title: The Academic Medical System: Reinvention to Survive the Revolution in Health Care.
abstract: Academic medical centers (AMCs) are presently facing enormous challenges arising from a prospective decline in government funding for research and education, shifting payment models emphasizing efficiency and value, and increasing competition. Left unabated, these challenges will drive many AMCs to de-emphasize or forsake their core missions in an effort to survive. Stemming from a symposium held at the 2015 Scientific Sessions of the American College of Cardiology titled, "The Academic Medical Center of the Future," we propose a series of changes, including internal restructuring, system-wide partnership, and novel approaches to support research and education, that are designed to better position AMCs to compete and face their growing challenges in a manner that preserves their essential missions. In aggregate, these changes will facilitate establishing the academic medical system of the future.
authors.affiliation: The CardioVascular Center, Tufts Medical Center, Boston, Massachusetts. Electronic address: mkonstam@tuftsmedicalcenter.org.
authors.forename: Marvin A
authors.initials: MA
authors.lastname: Konstam
authors.affiliation: Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Hill
authors.affiliation: Department of Medicine, Krannert Institute of Cardiology, Indiana University, Indianapolis, Indiana.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Kovacs
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, California.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Harrington
authors.affiliation: Warren Alpert Medical School of Brown University and the Lifespan Cardiovascular Institute, Providence, Rhode Island.
authors.forename: James A
authors.initials: JA
authors.lastname: Arrighi
authors.affiliation: Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Amit
authors.initials: A
authors.lastname: Khera
mesh_terms: D000046:Academic Medical Centers / Q000191:economics*; D002309:Cardiology / Q000193:education*; D003695:Delivery of Health Care / Q000458:organization & administration*; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D018166:Health Care Reform; D006801:Humans; D014481:United States
keywords: academic medical center; health care system; medical economics; medical education; research funding