The Academic Medical Center Today

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Abstract
Some recent circumstances, including the nation's economic difficulties, a probable physician surplus, a declining need for acute-care medical beds, and an overwhelming public perception that medical care is too expensive, are creating serious problems for academic medical centers today. To survive, many academic medical centers probably will make certain short-term adaptations that will be viewed as undesirable by many. We suggest four initiatives that may help academic centers maintain their vital national role. These initiatives include becoming major public advocates for the medical care needs of the least fortunate; a sharp reduction in the training of subspecialists; the commitment of more of their faculty practice income to academic research, teaching, and support of low-income students; and refocusing attention on the training of young persons to be the physicians of tomorrow.

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