How will restructuring work in your hospital? The helps and hinderances of a large academic environment

In summary, academic medical centers face the same issues as their less complex brethren. Sure there are some "downs." The high expectations that the staff bring to their jobs can decrease flexibility in role design, and the increased need to keep professionals together can make the organizational matrix more complex. But there are also some "ups." In many ways their size and specialty focus can help with the difficult decisions in the areas of patient grouping and service delivery approach. Taking advantage of the positives and working to minimize the effect of the negatives can allow even the most complex organization to restructure successfully. Academic medical centers may not be "just right" for restructuring, but they are definitely not "too big."