ABSTRACT
Because of their expanding budgets, facilities, enrollments and staff, and because of increasing responsibilities for rendering health services, academic health centers must make major administrative decisions. We believe that these centers should remain within the university structure to facilitate interdisciplinary education, should better integrate the activities of the faculties of their component schools, and should prepare more purposefully for the multiprofessional teams that will deliver primary care in the future. Basic-science departments should also improve institutional programs for serving students in all the health sciences. A center's chief administrative officer, a vice-president for health affairs, should have clearly defined lines of authority over the center's operations, including those of the university hospital. In spite of burdensome governmental regulations, centers should cooperate with legislative efforts in health planning, in developing experimental models for new delivery systems and in supporting studies that will underlie equitable rate regulation.