About the Book

umms logo

The University of Maryland Medical System (UMMS) is a national economic powerhouse. Its nine regional hospitals employ 15,000 people in the state of Maryland and generate nearly $3.5 billion in economic activity in the mid-Atlantic region. UMMS has more than 2,300 licensed beds, 115,000 annual patient admissions, and gross patient revenues of $2 billion. In addition, it is a regional referral center for trauma, cancer care, neurocare, cardiac care, women's and children's health, and physical rehabilitation. It also has one of the world's largest kidney transplant programs, as well as scores of other programs that dramatically improve the physical and mental health of thousands of people daily.

However, in the mid-1980s, the fate of this medical system was very much in doubt. Years of internal squabbling and bickering, poor business practices, and bad relationships with its physicians and state legislators placed what was then called the “University Hospital” on shaky ground, too wobbly to seriously compete with other hospitals. Indeed, it was grossly under-capitalized and hobbled by aging facilities and technologies, a culture that lacked accountability, a mission that focused more on teaching than on patient care, and a dwindling number of patient referrals.

ummc logo

In 1984, however, dramatic steps were taken to free the hospital from state ownership and university governance and create an independent board of directors. The alignment also created a new medical system that was able to stand on its own two feet and take responsibility for its own successes and failures in the years to come. Authors Morton Rapoport, M.D., and Stephen Schimpff, M.D., two doctors who played a major role in guiding UMMS through its formative years, chronicle how a fledgling university hospital in Baltimore became a thriving and internationally recognized academic medical center (now known as the University of Maryland Medical Center and the flagship of a thriving nine-hospital medical system. Their story chronicles a much-needed and long-overdue alignment of priorities and resources.

school logo

This critically needed “alignment,” was not only between the hospital and its affiliated medical school but also with the faculty physicians responsible for developing strong clinical programs that bring patients into the hospital and with state government, which ultimately assisted in recapitalizing its facilities. They also recount how alignment with business and other community leaders as well as the rate-setting commission was critical to their success. In addition, they describe in detail how their entrepreneurial leadership and management approach as well as a data-driven yet consensus-based strategic planning process contributed to the triumph of the Medical System, while allowing the affiliated University of Maryland School of Medicine, which today ranks as one of the best in the nation, to advance its research priorities.

But, this is not just a book about what went right. Rapoport and Schimpff, in addition to recounting their successes, describe the obstacles they encountered and mistakes they and others made over the past 25 years. More importantly, they describe how these obstacles and mistakes were overcome to achieve ultimate success. They, therefore, provide the “active ingredients” for aligning an academic medical center with its medical school, faculty physicians, and its patients.

Alignment is a must read not only for academic medical center administrators but for all health professionals as well as business professionals, because alignment—or its absence—is often the critical ingredient in managerial success or failure in every field. Alignment, therefore, is the ultimate “how to” book on achieving success not only in healthcare delivery but in all aspects of business, partnerships, and employee and customer relations.