Financial and clinical relationships between family practice and the academic medical center.

The clinical relationship of academic family practice units to their parent tertiary care medical centers was studied. We surveyed the designated family practice contacts in all U.S. medical schools and achieved a response rate of 84%. We found wide variations in the degree to which academic family practice units provide patient care within the walls of the academic medical center. Those departments which perform greater than 50% of their patient care within the academic medical center are more involved in medical center-sponsored alternative health care delivery systems. Residents of these programs receive more than 50% of their training at the academic medical center. These departments are also more likely to teach a required first-year course in the medical school curriculum. Finally, we found a suggestion, not statistically significant, that these departments may be supporting a greater proportion of their total budgets through clinical revenues. We conclude that academic family medicine units may benefit from closer clinical and financial connections to parent academic medical centers.