Medical schools and affiliated teaching hospitals (academic medical centers) in the United States educate and train physicians and other health professionals, perform the majority of National Institutes of Health–sponsored biomedical research, treat the sickest and most debilitated patients, and deliver substantial health care to the poor.1,2 The ability of academic medical centers to perform these vital health care roles is threatened by stagnating National Institutes of Health support for research, declining insurance reimbursement rates, skyrocketing malpractice insurance costs, a crisis in government health care programs, and an expanding population of uninsured and underinsured patients needing care.1
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