Faculty practice and university hospital integration.

With a long history as unique providers of health care, academic medical centers have been exempt from many of the troubles plaguing less distinguished health care organizations. But with the increasing dominance of managed care, academic medical centers are facing fierce competition from aggressive and often better organized providers. Burdened with cumbersome and tradition-laden organization structures and volatile turf issues, many academic medical centers are still in the early stages of collaborating with physicians and other providers to develop the care continuums being demanded by payors. Few are operating as truly integrated delivery systems. As the stakes get higher, academic medical centers must accelerate development of health delivery systems by integrating faculty practice ambulatory services with university hospital patient services and those of network partners. Together these services can form the foundation of a system that ultimately provides a complete array of inpatient and outpatient services and is supportive of teaching, research and faculty and staff entrepreneurial activities.