A University of Alabama plan to improve productivity in the medical school by reallocating institutional funds and changing the handling of professional practice revenues is described, and its effects, strengths, and weaknesses after the first three fiscal years of implementation are examined. Despite some problems, the plan appears to be…

The choice of the Oregon Health Sciences University to change its status from public to private is discussed, focusing on the reasons for the change (decreased public funding, health care market competition, bureaucracy), the political process of building support for legislation, key features of restructuring, challenges faced, and lessons…

Issues and difficulties in the management of formal affiliations between medical schools and managed health-care organizations are discussed, based on the experience of the Case Western Reserve University (Ohio) medical school and the Henry Ford Health System. Difficulties include differing institutional cultures, departmental authority over…