For over 100 years, academic medical centers (AMCs) have been the bastion of medicine; providing outstanding care, incubating the discoveries that have improved health care around the world, and training the next generation of doctors and scientists. Delineating the issues that have lead to the current crisis in AMCs, this book provides a radically different model for achieving success. The model presents four intersecting spheres of action, each of which is necessary but none of which can stand alone. The book presents an in depth analysis of the issues and challenges facing AMCs and offers recommendations that allow them to achieve their core mission — the delivery of outstanding patient care.