The plight of academic health centers (AHCs) in the United States is
the plight of the health of our citizens. What occurs in our academic centers
affects the education and training of physicians, nurses, and other health
professionals; influences future medical research and discovery; and ultimately
affects patient care throughout the United States and, in many ways, the world.
This issue of THE JOURNAL presents 5 commentaries on this subject written
by some of the United States' outstanding leaders in medicine. Pardes1 outlines many of the reasons why academic health care
is in peril. These include the financing of medical service under managed
care; the role of AHCs in a marketplace environment; government cutbacks affecting
medical education; decreasing numbers of medical school applicants; and the
frustration of leaders of AHCs, who find it impossible to continue their clinical,
education, and research missions in an overtly hostile financial environment.
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