Revitalization of the Warren G. Magnuson Clinical Center at the National Institutes of Health.

For nearly 45 years the Warren G. Magnuson Clinical Center has been the site of the intramural clinical research of the National Institutes of Health. It has served as the largest clinical research facility for the nation and the site for training many of the clinical investigators in the nation's academic medical centers. Research at the Clinical Center has focused on study of orphan diseases and phase 1 and 2 clinical trials, and this research emphasis has made it a special national resource. Over the last decade there has been a dramatic decline in the number of patients seen at the Clinical Center, as well as a perceived decrease in the quality of research performed at the center. The decreased activity is related in part to fiscal constraints and the impact of the changing health care delivery system. The trends at the Clinical Center are particularly distributing because they parallel what is happening at academic health centers across the country. Because its success is viewed as vital to national clinical research, a major effort has been undertaken to revitalize the center. This paper reports on the plans and activities undertaken to reorganize the center's management, revitalize its infrastructure for conducting clinical research, establish vital clinical research training, and promote partnerships with extramural investigators who will benefit from access to the center. The hope is that the model established at the NIH Clinical Center will assist in the revitalization of clinical research across the nation.