In the corporate world, success is usually measured as sustained growth, increased market share, and profitability. These goals are typically set by top management and incorporated into the business plans of the various organizational components. Academic and clinical goals are considered in tandem with institutional goals. All staff share a common view on how to maximize the aggregate bottom line and how aggregate surplus funds should be used across the academic and clinical enterprises. The AMC is organized around a single decision point with the authority to act on its decisions.
All employees can articulate the organization's major goals.
In response to market pressures, AMCs have made tremendous progress in recent years in defining their strategic direction and launching major initiatives, such as mergers, primary care, and multidisciplinary centers. However, it has proved challenging to align the clinical department priorities with those of the entire institution. In an AMC, each revenue stream typically belongs to a single organizational component, with its own bottom line. Most AMCs evaluate the performance of their leaders, the dean and others, based, in part, on the bottom-line performance of those leaders. Motivation to optimize profit at the unit level may compromise the AMC's ability to attain its overarching strategic and financial objectives.