I have been studying or working in medical schools since
1972. I have seen many changes in that time and not all of it is good. In fact
many of the changes I have seen have been for the worse. Among those things
that have occurred to the detriment of medical schools in general and mine in
particular has been the corporatization of medical schools. Many would suggest
that what I am calling medical school corporatization represents a long overdue
application of sound business principles and professional management to the
operation of medical schools. However, I have seen over and over again, that in
reality the major effect of such corporatization has been the distortion and
abandonment of long standing academic
values which have allowed education and scholarship to thrive. They have often
been replaced with inflexible rule-driven bureaucratic organization driven by
the apparent need to control.
Among the reasons that this corporatization has taken place
is because of the relationship between medical schools and hospitals.
Educational institutions generally have a collegial style of operation with a
relatively flat hierarchy. Hospitals, in contrast, seem to be dominated by
highly vertical hierarchies with strongly bureaucratic inclinations. Moreover the educational institutions in
these partnerships are generally much smaller than the clinical institutions
and the result is dominance of the hierarchical culture at the expense of the
collegial academic culture. The values
of education, scholarship and collegiality are threatened and replaced by the
values, or in fact lack of values, which spring from bureaucracy.
In this type of organization the line academic
organizational hierarchy is diminished and becomes dominated by the support
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.