In this compelling book, physicians Morton Rapoport and Stephen Schimpff describe how a failing university hospital in Baltimore became a thriving academic medical center and the flagship of a nine-hospital system. The story is compelling because it demonstrates the absolute importance of establishing alignment between the hospital and the affiliated medical school. But that was not enough; alignment was also necessary with the faculty physicians since they were the ones who developed strong clinical programs and brought patients to the hospital; with state government which ultimately assisted in recapitalizing the facilities; with business and community leaders that assisted with support; with the rate-setting commission which was critical for establishing adequate revenues and with many others. Other keys to success were an entrepreneurial leadership and management approach; a data-driven yet consensus-based strategic planning process; and separation in 1984 from state ownership and university governance. Rapoport and Schimpff point out obstacles encountered and mistakes made over 25 years since separate governance was enacted yet how these were overcome with ultimate success. And they put the entire picture into the perspective of any academic medical center in America that needs alignment among its hospital, medical school and faculty physicians and for that matter any community hospital which should seek alignment with its voluntary physicians. This is a must read for all in the health professions, not just those in academic medicine. And it is an important subject for all business leaders since alignment--or its absence--is so often the critical ingredient in managerial success or failure.
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