Residency education in for-profit general hospitals

In May, 1983, when the new University of Louisville teaching hospital was opened under the auspices of Humana Corporation, it became the first university hospital operated by a for-profit corporation. We describe the agreement that launched this venture and summarize the experiences of the Department of Psychiatry and Behavioral Sciences with Humana, Inc., during the past 3 years. We review our impressions of both the positive and negative effects that the for-profit managing style has had thus far on the teaching programs of the Department. Based on our experiences, there are financial and other benefits, but we think that there are also potential dangers for the future of psychiatric education inherent in the administration of a teaching hospital by a for-profit corporation. The "atmosphere of business" that pervades the climate of opinion in the United States in the 1980s and is merely epitomized by the increasing role of enterpreneurial groups in medicine can be antithetical to principles of psychiatry and has implications for psychiatric education in the future. Awareness of these developments is a task for psychiatric education and, when it is possible, comparative studies of residents and their programs in nonprofit and for-profit hospitals should be conducted.