New book examines, contrasts major reorganizations of medical schools at Hopkins and Penn in the 1990s

In the 1990s, two of the nation's leading medical schools — Johns Hopkins University and the University of Pennsylvania — underwent dramatic transformations in their institutional organization and governance. At Penn, trustees needed to find a way to divest a vast, money-losing health system from university ownership before it affected the medical school's financial stability. At Hopkins, longstanding conflicts between the leaders and governing boards of the separate medical school and hospital system demanded the creation of a single, overarching governing entity.

In Governance of Teaching Hospitals: Turmoil at Penn and Hopkins, John Kastor, a noted cardiologist (University of Maryland School of Medicine) and a recognized authority on the administration of medical schools, offers an in-depth look at these historic changes, based on interviews with more than 300 administrators, educators and medical professionals at both Penn and Hopkins, along with other institutions. Taking readers step by step through the crises that initiated changes at each institution and comparing the decision-making process that transformed them, Kastor reveals how American medical schools are administered and how the structure of governance affects the performance of medical schools in terms of research, training and clinical care.

For anyone involved or interested in medical education, Governance of Teaching Hospitals provides a deeper understanding of how teaching hospitals function and why people leading hospitals and universities do what they do, and it will help guide those who lead teaching hospitals to analyze more successfully the problems confronting their institutions. (January, 368 pages, $55 hardcover)

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