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Previous Volume 341:1092-1096 September 30, 1999 Number 14

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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After a quarter century of relative plenty, academic medical centers find themselves in a serious financial squeeze that is beginning to compromise their triple mission of teaching, research, and clinical care. This squeeze reflects competitive pressures to reduce costs in a managed-care environment, intensified by Medicare cuts mandated in the 1997 Balanced Budget Act.¹ Teaching hospitals are no longer able to bill at rates that reflect the extra costs of their academic role — traditionally representing a premium of about 30 percent.² Most have sought to make up in patient volume what they have lost in income margins. This survival . . . [Full Text of this Article]

The Evolution of Academic Medicine

From Medical School to Integrated Delivery System

Harms to the Educational Mission

Educational Benefits of Managed Care?

Hospital Haves and Have-Nots

The Outlook

References

Related Letters:

The Effect of Managed Care on Medical Education
Light D. W., Harrop D. S., Weinberger S. E., Rosenblatt M., Kressel H. Y., Sartin J. S., Gottfried R. N.
Extract | Full Text  
N Engl J Med 2000; 342:1140-1141, Apr 13, 2000. Correspondence

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