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October 28, 1992

The Academic Medical Center and the Health of the Public-Reply

Author Affiliations

University of California, San Franicisco

JAMA. 1992;268(16):2167-2168. doi:10.1001/jama.1992.03490160036016

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In Reply.  —We thank Drs Gellert and Wittig for their comments and agree with much of what they say. Their letters highlight two areas that academic health centers have not addressed adequately: the discontinuity between the programs in academic health centers and the needs of local populations and the disincentives toward primary care training and practice. Incentives toward high cost, tertiary, hospital-based treatment, and training at the expense of care of persons in the community are a general problem; Health of the Public focuses on academic health centers because of their pivotal role in influencing the attitudes and careers of future health professionals, and because their prestige and authority could serve as a potent ally in the struggle for community health.Dr Gellert asks for specifics and "operationally implementable recommendations." The objectives proposed in our article are general tenets that address the current imbalance in the education, patient care, and