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Governance of Teaching Hospitals

, 368 pages

15 halftones

December 2004



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Governance of Teaching Hospitals

Turmoil at Penn and Hopkins

What forces lead to changes in governance among medical schools and their associated teaching hospitals? To what extent do such changes affect how well those schools and hospitals do their work? In this book, John A. Kastor, M.D., focuses on the academic medical centers of the University of Pennsylvania and the Johns Hopkins University, two institutions that underwent dramatic change in governance during the late 1990s.

Drawing on extensive interviews with more than three hundred administrators, physicians, and other medical professionals at Penn, Hopkins, and elsewhere, Kastor identifies the factors that influenced changes in governance at these two institutions. Chief among these, he finds, are structure, personality conflicts, and current events. This book will be of interest to administrators of teaching hospitals as well as professionals in health policy and management.

John A. Kastor, M.D., is former chair of the Department of Medicine and a cardiologist at the University of Maryland School of Medicine. He is the author of Mergers of Teaching Hospitals in Boston, New York, and Northern California.

"For anyone involved or interested in medical education, Governance of Teaching Hospitals provides a deeper understanding of how teaching hospitals function and why people leading hospitals and universities do what they do, and it will help guide those who lead teaching hospitals to analyze more successfully the problems confronting their institutions."

"Shows the resilience of these large institutions and their ability to absorb and recover from crises."

"Kastor has provided us with great gossip, complete with comprehensive and detailed accounts of fascinating events, and with an important reminder of what can happen when an academic medical center confronts the challenges of the contemporary health care delivery system."

"John A. Kastor offers a peek through the curtains in his book, Governance of Teaching Hospitals: Turmoil at Penn and Hopkins."

"[A] readable, carefully constructed, and useful analysis... [with] a wealth of detail and a cast of hundreds... Details of the power struggles will prove to be the book's strongest feature. This book should be of interest and value not only to those who are directly involved in leadership roles at academic medical centers but also to anyone interested in the success of such institutions."

"A rich and often fascinating 'insider' view... This book warrants close attention and wide readership, not only by those interested in academic medicine, but also by managers of all health care institutions."

" Governance of Teaching Hospitals looks fantastic. What an important contribution [Kastor] has made to academic health centers. Thorough, well-presented research like [his] is sure to assist teaching hospitals around the nation in their attempts to provide the best patient care, doctor training, and research."

"This is a highly readable, painstakingly researched account of the recent travails of two of the nation's most important academic health centers. The author marshals an extraordinary amount of primary data that paint a compelling, convincing, and very objective account of the events of these institutions' recent, turbulent histories."

"Engagingly written and packed full of information. I could not put it down... Great book!"

"This book deserves close attention among a select readership, especially those interested in academic medicine... Above all, the volume contains a wealth of information relating to two important American medical schools undergoing significant structural change."

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