I include a discussion of the reasons for these political difficulties and their potential applicability to the plans of aca- demic meclical centers. The scale of the medical enterprise is far greater than for related commercial technology initiatives at universities. Nevertheless, the outcomes of other public-private joint ventures are relevant to the likely results of the university hospital reorganizations. As of 1993-94, patient practice revenues were still posting real increases. When I proposed this theory to medical school deans and other people associated with academic medi- cal centers, I was met with what might politely be called skepticism.
Extensive literature discusses the importance of scientific diffusion for growth.
Another situation relevant to academic medical centers, al- though not directly related to hospitals, is if, through a biotech joint venture, a particularly profitable product is developed. The possibility then exists for an AZT-type response.