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ARTICLE |

The Town-Gown Syndrome

Robert G. Petersdorf, MD
JAMA. 1987;257(18):2478-2479. doi:10.1001/jama.1987.03390180096031.
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ABSTRACT

By the "town-gown syndrome" I mean the frictional interface between practicing physicians in private practice in a community and the full-time faculty of the medical school. Usually the syndrome involves faculty in clinical departments, although medical school administrators, hospital directors and staff, and sometimes even university administrators are involved. Basic science faculties are usually spared.

The basis for the town-gown syndrome is fundamentally economic. Practicing physicians resent that full-time faculty, who derive at least part of their income from the university, compete with them for patients. Practitioners also object to the fact that academic practices are subsidized because they are carried out in university facilities. The practicing community views the academic practitioner as "unfair competition" with which they as taxpayers (in the case of state-supported medical schools) or contributing alumni (in private medical schools) should not have to contend.

In fact, the economic competition between academic clinicians and private practitioners

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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