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Commentary
November 2, 2011

Academic Medical Centers—Organizational Integration and Discipline Through Contractual and Firm Models

Author Affiliations

Author Affiliations: The Johns Hopkins University, Baltimore, Maryland (Mr Daniels); and University of Toronto, Toronto, Ontario, Canada (Ms Carson).

JAMA. 2011;306(17):1912-1913. doi:10.1001/jama.2011.1606

Over the last several decades, substantial literature has developed regarding the roles, functions, and resources of—as well as the challenges facing—the academic medical center (AMC). Yet with some notable exceptions, little of the discussion surrounding the AMC has been informed by organizational theory, leaving underexamined how various organizational structures and approaches may reduce or exacerbate tensions among the AMC's divergent stakeholders. Far from a purely theoretical inquiry, the exploration of how AMC organizational structures affect allocation of resources and sharing of risk as well as institutional abilities to respond to external and internal changes has profound implications for how these bastions in the landscape of modern health care can best achieve their scientific, financial, educational, and societal goals.

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