Success factors in merging teaching hospitals.

Merger has served as a major strategy for the leaders of academic medical centers (i.e., teaching hospitals) who are pursuing health system development for their institutions.

Toward a 21st-century health care system: recommendations for health care reform.

The coverage, cost, and quality problems of the U.S. health care system are evident.

Adverse renal and metabolic effects associated with oral sodium phosphate bowel preparation.

Colorectal cancer can be prevented by the removal of adenomatous polyps during screening colonoscopy, but adequate bowel preparation is required. Oral sodium phosphate (OSP), an effective bowel purgative, is available over the counter and requires a substantially lower volume than polyethylene glycol-based preparative agents. Accumulating reports implicate OSP in electrolyte disturbances as well as acute kidney injury (AKI) in a syndrome termed phosphate nephropathy (a form of nephrocalcinosis).

Financial anatomy of biomedical research.

Context: Public and private financial support of biomedical research have increased over the past decade. Few comprehensive analyses of the sources and uses of funds are available. This results in inadequate information on which to base investment decisions because not all sources allow equal latitude to explore hypotheses having scientific or clinical importance and creates a barrier to judging the value of research to society.

Why have academic medical centers survived?

Over the past decade, many observers predicted the demise of the academic medical center (AMC) due to competition from community hospitals and physicians, fragile finances, inefficiency, and organizational complexity. In 2004, we interviewed 23 AMC and community hospital administrators to determine why those predictions have proven unfounded, learn the leaders' current concerns and priorities, and to identify desirable changes. Chief concerns were reimbursement uncertainty, federal research policy, ineffective internal decision-making, and clinical quality (mentioned in more than 75% of interviews).

Partners HealthCare: an exercise in marital counseling.

The high cost of health care in Boston led industry and government to expand managed care. The expensive academic health centers had the choice of closing, downsizing, merging, and/or integrating. The MGH and BWH chose to develop Partners HealthCare (PHCS) an integrated healthcare system that maintained the identities of the founding institutions.

Medical innovation and institutional interdependence: rethinking university-industry connections.

University-industry research collaborations have been key to a continued high degree of technological innovation in medicine. Recently, however, critical questions have been posed about the potential negative aspects of highly productive means of encouraging innovation. Concerns center on blurring roles between academic research and the commercial world and the implications of universities' newfound readiness to benefit financially from their intellectual property.