Understanding Academic Medical Centers: Simone’s Maxims
Academic medical centers today represent a unique fusion of traditional academia, hospital functions, several levels of education, and, above all, patients. They are complex organizations trying to discharge an often conflicting melange of responsibilities. This complexity has grown in recent years with the increasingly rapid rate of change (1), stressing both faculty and leadership (2, 3). Lamenting the toll of change is not new (4). However, the qualitative difference in recent change is underscored by the shift in focus of two articles, 15 years apart, on academic governance by Petersdorf (5, 6), especially as they have affected deans and their dramatically shrinking tenures. Economic turmoil and its consequences are blamed most often for the angst in academic medical centers (7). And yet, some blame the faculty and leadership for not changing fast enough (8) or for choosing doomed strategic pathways in response to those pressures (9). In fact, a Forum on the Future of Academic Medi