Factors affecting the optimal size of an integrated health care delivery system in an academic medical center are discussed, including: the institution's structure for survival; technology, innovation, and health care costs; and specific characteristics of the institution's education, research, and patient care missions. Several alternative…

Strategies used at several medical schools to address common issues in ambulatory care clerkship programs are presented. These include institutional and policy concerns (institutional resistance, financing, faculty incentives), administrative and implementation problems (logistics, faculty recruitment, student recruitment/placement), and…

Organizational aspects of the Shock Trauma Institute at Loyola University Medical Center (Illinois) are described. The philosophies and conditions that helped determine the institute's organizational structure and success are analyzed, and the institute's role as a multidisciplinary research program is discussed. Structures of the clinical,…