THE ACADEMIC-HEALTH-CENTER AND THE HEALTHY COMMUNITY

US medical care reflects the priorities and influence of academic heal th centers. This paper describes the leadership role assumed by one ac ademic health center, the State University at Buffalo's School of Medi cine and Biomedical Sciences and its eight affiliated hospitals, to Se rve its region by promoting shared governance in educating graduate :I physicians and in influencing the cost and quality of patient care. C ooperation among hospitals, health insurance payers, the business comm unity, state government, and physicians helped establish priorities to meet community needs and reduce duplication of resources and services ; to train more primary care physicians; to introduce shared governanc e into rural health care delivery; to develop a regional management in formation system; and to implement health policy. This approach, spear headed by an academic health center without walls, may serve as a mode l for other academic health centers as they adapt-to health care refor m.