STRATEGIC-PLANNING FOR ACADEMIC HEALTH CENTERS

The mission, indeed the very existence, of the traditional academic he alth center is under siege. Changes in the financing and delivery of: health care threaten the clinical revenue used to subsidize the tripar tite mission of education, research, and patient care. Market practice s, driven by the growth of managed care, will intensify the impact of declining revenue to threaten the actual patient base necessary to sus tain these endeavors. The survival of academic health centers depends on their ability to change. This change will not be easy, and the size of the collective academic medical establishment will decrease. Succe ssful enterprises will be those that go beyond incremental, reactive a djustments. Nothing short of organizational redesign, creation of stra tegic partnerships, and adopting a cybernetic model of continuous meas urement, improvement and adaptability will suffice. Using the elements of a strategic planning exercise, this paper reviews the background i ssues that have produced the current predicament and explores the stre ngths and weaknesses inherent in academic institutions. Elements of an ''idealized'' academic. health center are postulated and, finally, sp ecific strategies that might be considered in creating a relevant and secure future are proposed.