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The Rise of the Academic Clinician

Am J Dis Child. 1985;139(9):861. doi:10.1001/archpedi.1985.02140110015012.
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Sir.—The economic realities that are refashioning health care delivery may well bring into prominence a new group of academic clinicians, who will share in the direction and control of academic affairs.

For many academic centers, outside funding has become more unreliable.1 Austerity measures have stabilized the growth of federal grants,2 contributions from eleemosynary foundations have contracted, 3 legislatures have frozen health care budgets, and support for indigent medical services is becoming politically unattractive.4 With uncertain access to such sources, the future weal of academic departments increasingly will depend on billings from routine patient care, despite the dangers of relying too heavily on practice-generated income.5 Ironically, while dependence on patient billings is growing, the competition has become fierce. Success in this competitive struggle will be secured only by offering a superior product—higher quality medical care, a better hospital experience, a unique portfolio of services and


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