Teaching Hospitals

Abstract

Teaching hospitals, which developed in response to changes in medical education in the early 20th century, have three missions that are critical to the maintenance of clinical excellence: graduate medical education, clinical and basic research, and the provision of a spectrum of patient care. The revenues that fund these interrelated activities derive largely from the care of patients and -- to a lesser extent -- grants, but they are dispersed in a complex web of cross-subsidies. Now, however, as managed-care plans proliferate and competition in prices becomes the watchword of reform, the commitment of third-party payers to finance the expensive . . .