Policy-making and governance in academic health centers

Treating academic health centers (AHCs) as unique organizations that merit serious investigation, the authors outline key changes which have shaped today's AHCs, discuss various modes of AHC organization and governance, and analyze certain factors which make AHC policy-making so complex. In addition, they assess the relevance of certain policy-making models, concluding that no one model completely describes AHC governance. They suggest that the contingency theory of organizations offers a useful perspective on AHCs and point to matrix management as one contemporary method being tried in an effort to cope with the problems of AHC governance. Finally, the authors offer a set of decision-making continua as an alternative to governance models for analyzing policy-making in AHCs.