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Mergers of Teaching Hospitals in Boston, New York, and Northern California

John A. Kastor

Publication Year: 2001

If a teaching hospital loses funding, what is the next option? Mergers of Teaching Hospitals in Boston, New York, and Northern California investigates the recent mergers of six of the nation's most respected teaching hospitals. The author explains the reasons why these institutions decided to change their governance and the factors that have allowed two of them to continue to operate while forcing the third to dissolve after only 23 months of operation. The case studies contained within this book rely on an impressive amount of research. Notably, instead of citing only published articles and books, the author includes information from numerous, extensive personal interviews with key participants in the various mergers. With this research the author not only presents to the reader a picture of why these mergers came about, but also investigates how the organizations have fared since joining together. The mergers are analyzed and compared in order to identify various methods of merger formation as well as ways in which other newly formed hospitals might accomplish a variety of important goals. Offering a spectacular account of some of the mergers that occurred in the health care field at the close of the twentieth century, these stories provide insight into academia's relationship with teaching hospitals and the challenges involved in bringing prestigious and powerful medical institutions together. The institutions discussed are Partners, the corporation which includes the Massachusetts General Hospital and the Brigham and Women's Hospital, New York-Presbyterian Hospital, the union of the New York and Presbyterian hospitals in New York City, and the UCSF Stanford, the merged teaching hospitals of the University of California, San Francisco and Stanford. This book will particularly appeal to professionals and academics interested in medicine, business, and organizational studies. John Kastor is Professor of Medicine at the University of Maryland School of Medicine. From 1984 to 1997, he was Theodore E. Woodward Professor of Medicine and Chairman of the Department of Medicine at Maryland and Chief of the Medical Service at the University of Maryland Hospital. Dr. Kastor is also the author of Arrhythmias.

Published by: University of Michigan Press


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pp. vii

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pp. ix-xii

In December 1993, those of us in academic medicine were amazed to learn that two of the country's premier teaching hospitals, the Massachusetts General Hospital and the Brigham and Women's Hospital in Boston, were merging. How did these hospitals, so proud of their histories and traditions and fierce competitors since the Brigham opened in 1913,...

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Chapter 1. Introduction

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pp. 1-13

This is a book about the merging of six of America's leading teaching hospitals, where the faculties of five of the country's most distinguished medical schools instruct their students and trainees in clinical medicine. The force driving the mergers was economic, and the name of the force was managed care....

Part 1. Partners

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pp. 15-17

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Chapter 2. Formation

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pp. 19-53

On Tuesday, January 5, 1993, Dr. Daniel C. Tosteson, dean of the Harvard Medical School, convened the first meeting of the Harvard Medical Planning Group, a committee of 15 charged with uniting the five Boston hospitals where Harvard students receive their clinical instruction. Three doctors and executives - the chairman of the board of trustees,...

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Chapter 3. Development

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pp. 54-112

As 1994 began, the founders of the union of the Brigham and Women's and Massachusetts General Hospitals proceeded to structure the merger and find a name for their new creation. The boards of trustees had accepted the concept of the merger early in December 1993....

Part 2. NewYork-Presbyterian

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pp. 113-118

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Chapter 4. Formation

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pp. 119-168

The view through the windows in the office of Dr. William T. Speck on the fourteenth floor of the Atchley Building* of the Columbia-Presbyterian Medical Center faces the broad expanse of the Hudson River and New Jersey to the west and the length of Manhattan Island to the south. The view to the north showed Speck his deeply troubled responsibility, the...

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Chapter 5. Development

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pp. 169-258

Having accepted the concept of merging their institutions in June 1996, the governors of the Society of the New York Hospital and the trustees* of the Presbyterian Hospital in the City of New York and their executives spent the next 18 months clearing up the many legal, financial, and regulatory requirements for the new hospital. The founders eschewed...

Part 3. UCSF Stanford

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pp. 259-263

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Chapter 6. Formation

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pp. 265-326

In April of 1995, Gerhard Casper, president of Stanford University, and Dr. Joseph B. Martin, chancellor of the University of California-San Francisco, took their renowned "walk in the woods."* Casper and Martin, who were attending a meeting of the California Business Higher Education Forum in Palm Springs, discussed how they could share more...

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Chapter 7. Development

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pp. 327-409

Before the merged corporation was officially established on November 1, 1997, UCSF Stanford Health Care had acquired headquarters of its own but not at either UCSF or Stanford. "There had to be firewall between UCSF and the UCSF Stanford, which mustn't be viewed as a shadow of the University of California," says Bruce Wintroub, the recently...

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Chapter 8. Conclusions

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pp. 411-440

"The big picture" in the merger scene, suggests Dr. Kenneth I. Shine, president of the Institute of Medicine in the National Academy of Sciences, "is driven by the effort of the teaching hospitals to dominate the market" in their communities. Despite what the consultants say, "saving money by consolidation turns out to be a minor plus. The leaders of...


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pp. 441-469


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pp. 471-487

E-ISBN-13: 9780472024735
E-ISBN-10: 0472024736
Print-ISBN-13: 9780472089352
Print-ISBN-10: 0472089358

Page Count: 504
Illustrations: 3 tables
Publication Year: 2001