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  • Print publication year: 2005
  • Online publication date: November 2009

3 - Stronger leadership in and by academic health centers

    • By John G. Nackel, Executive Vice President US Technology Resources, Aliso Viejo, California, USA, Douglas S. Wakefield, Professor and Head of the Department Health Management and Policy in the College of Public Health at the University of Iowa, Michael G. Kienzle, Special Assistant to the Dean and Director Economic and Business Development in the College of Medicine at the University of Iowa, R. Edward Howell, Vice President and Chief Executive Officer University of Virginia Medical Center, Robert P. Kelch, Executive Vice President Medical Affairs at the University of Michigan, Edward D. Miller, Chief Executive Officer Johns Hopkins Medicine; Dean of the Medical Faculty Johns Hopkins University, Steven Lipstein, President and Chief Executive Officer BJC Health Care
  • Edited by Don Detmer, University of Virginia, Elaine Steen, University of Virginia
  • Publisher: Cambridge University Press
  • DOI: https://doi.org/10.1017/CBO9780511543487.005
  • pp 73-118

Summary

Introduction

Leaders of academic health centers (AHCs) have always experienced a wide range of formidable challenges during their tenure. AHCs are complex organizations to lead because of their multiple missions, substantial size, highly specialized products and services, diverse internal and external constituencies, and culture marked by autonomy of faculty and departments. They operate as academic, business, and (in many cases) public organizations simultaneously, in an industry that is in the midst of evolving its production modes (i.e., from cottage to manufacturing to knowledge-based). Across AHCs, financial threats abound as a result of reduced government support and declining clinical revenues.

In many cases, governance structures are being or need to be modified because governing boards do not always facilitate needed change and internal decision-making processes are not always efficient. Moreover, the career path of AHC leaders is often antithetical to the development of skills necessary for effective leadership. Further, a coherent strategy to build future leaders is lacking in most AHCs. Planning for future leadership is often equivalent to establishing a search committee when a key position becomes vacant.

An array of societal, economic, and technological forces is creating a new and as yet uncharted terrain for AHCs. Academic health center leaders must address demographic shifts, new capabilities arising from information and communications technology, and growing consumer expectations for speed and customized products and services. These changes require that organizations assume new roles, acquire new capabilities, develop new business models, and interact with both customers and staff in new ways.

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