The Social Missions of Academic Health Centers

Academic health centers have long enjoyed positions of power and prestige in the health care system. However, the restructuring of health care — exemplified by the spread of competition and managed care — threatens the intricate system of financial and clinical relations on which these institutions depend.1,2 Although these challenges have led to considerable discussion about the appropriate role of academic health centers and how they should be organized and financed, a fundamental question is generally overlooked: Why are academic health centers worth our concern and protection? More specifically, is there any reason they should not be left to . . .