Although the term medical center is sometimes loosely used to refer to any concentration of health care providers including local clinics and individual hospital buildings, the term academic medical center more specifically refers to larger facilities or groups of facilities that include a full spectrum of health services, medical education, and medical research.
The major medical centers represent the premier sites of health care in the United States. They vary greatly in their organization, the services they provide, and their ownership and operation.
Overview
In the United States, ownership of the health care system is mainly in private hands, though federal, state, county, and city governments also own certain facilities. Many major hospitals, generally the backbone of any medical center, are non-profit and many of these have their origins in religious organizations. Despite their non-profit status, affiliation with private ventures and major medical schools often allows them to maintain state-of-the-art facilities and services. The non-profit hospital's share of total hospital capacity has remained relatively stable (about 70%) for decades.[1] There are also privately owned for-profit hospitals as well as government hospitals in some locations, mainly owned by county and city governments.
Major medical centers provide many specialized services, some even containing multiple specialized hospitals and clinics each dedicated to specific types of patients and/or services. Additionally, they are centers of medical education, centers of medical research, and incubators for medical innovation and technology. A given medical center may include a medical school in the same complex as the rest of the facilities or may be closely affiliated with a medical school on a nearby campus. Similarly, a given medical school may be closely associated with multiple tightly linked hospital campuses which function to some degree as a unit though the group may not be referred to as a single medical center (e.g. the Harvard Medical School network of teaching hospitals).
There are about 1,100 teaching hospitals in the United States. Approximately 375 of the larger institutions belong to the Association of American Medical Colleges’ Council of Teaching Hospitals and Health Systems (COTH). COTH teaching hospitals train about 75 percent of residents yearly and provide more than 40 percent of all hospital charity care in the nation.
Although any rankings of medical centers are highly subjective, this section describes some of the largest and most prominent centers in the nation. Note that the rankings and importance of individual hospital facilities may be different from the medical centers that they belong to.
Alabama
UAB Health System
The UAB Health System (UABHS) is a partnership between UAB and the University of Alabama Health Services Foundation (UAHSF), a private not-for-profit medical practice made up of the faculty of the UAB School of Medicine. UABHS is governed by a board of directors which has representatives of UAHSF, the University of Alabama Board of Trustees, and UAB administrators. The UAB president is the ex officio chairperson of the UAB Health System. The CEO of the UABHS reports directly to the UAB Health System board and is appointed by the chairman of the board.
UAB Hospital is the central institution of UABHS. It was formed as University Hospital in 1945 from the merger of Jefferson Hospital and Hillman Hospital, two private hospitals in the Southside of Birmingham acquired by the University of Alabama Board of Trustees. University Hospital was created to serve as the primary teaching hospital for the School of Medicine.
Callahan Eye Foundation, founded independently as the Eye Foundation Hospital in 1963 and merged into UABHS in 1973,[3]
UAB Medicine Women and Infants Center
UAB Hospital-Highlands. Formerly HealthSouth's flagship medical center in the Southside, UABHS acquired it in 2006. Highlands now serves as an acute care hospital. In 2011, Highlands was merged completely into UAB Hospital.
Spain Rehabilitation Center
UAB Medicine Health Centers, clinics operated and staffed by UABHS located throughout central Alabama
Viva Health, a health maintenance organization (HMO) which is a subsidiary of Triton Health Systems, a limited liability corporation based in Birmingham and owned by the UABHS
As of 2022–23, U.S. News & World Report ranked Cedars-Sinai the best hospital in California and the western United States. It ranked as the 2nd-best hospital in the entire United States (only behind Mayo Clinic) and was placed nationally in 11 adult medical specialties and rated high performing in 10 adult procedures and conditions.[4] Cedars-Sinai is a teaching hospital affiliate of David Geffen School of Medicine at the University of California, Los Angeles (UCLA), which was ranked #19 on the U.S. News 2022-23 Best Medical Schools: Research.[5]
Lake Nona Medical City is a 650-acre (260 ha) health and life sciences park in Orlando, Florida, United States. It is located near Orlando International Airport and within the master-planned community of Lake Nona. The city is home to the University of Central Florida's Health Sciences Campus, which includes the university's College of Medicine and Burnett School of Biomedical Sciences. In the future, the campus will also house UCF's University of Central Florida College of Nursing, the University of Central Florida College of Dental Medicine, and a teaching hospital.
The medical city also includes the Sanford-Burnham Medical Research Institute, Nemours Children's Hospital, a University of Florida Academic and Research Center, and Valencia College at Lake Nona. In addition, the Orlando Veterans Administration Medical Center, began seeing clinical patients from February 2015.
Georgia
Emory University Medical Center
Emory University Hospital is a 733-bed facility in Atlanta, Georgia, specializing in the care of acutely ill adults. Emory University Hospital is staffed exclusively by Emory University School of Medicine faculty who also are members of The Emory Clinic. The hospital is renowned as one of the nation's leaders in cardiology and cardiac surgery, oncology, transplantation, ophthalmology, and the neurosciences.[8][9][10]
The Illinois Medical Districtis a special-use zoning district two miles west of the Loop in Chicago, Illinois. The Illinois Medical District consists of 560 acres of medical research facilities, labs, a biotechnology business incubator, a raw development area, four major hospitals, two medical universities, and more than 40 health care related facilities. The IMD has more than 29,000 employees, 50,000 daily visitors and generates $3.4 billion in economic opportunity. The Illinois Medical District is the largest medical district in North America, and has the most diverse patient population on the continent.
Northwestern Memorial Hospital (NMH) is a nationally ranked academic medical center located in the Streeterville neighborhood of Chicago, Illinois. It is the flagship campus for Northwestern Medicine and the primary teaching hospital for the Feinberg School of Medicine at Northwestern University.[16] Affiliated institutions also located on campus include the Ann & Robert H. Lurie Children's Hospital with Level I pediatric trauma care and the Shirley Ryan AbilityLab, a leader in physical medicine and rehabilitation.
Ann & Robert H. Lurie Children's Hospital of Chicago (formerly Children's Memorial Hospital) is a nationally ranked pediatric acute care teaching hospital located in Chicago, Illinois. The hospital has 360 beds[17] and is affiliated with the Northwestern University Feinberg School of Medicine. The hospital provides comprehensive pediatric specialties and subspecialties to infants, children, teens, and young adults aged 0–21[18][19] throughout Illinois and surrounding regions. Lurie Children's also sometimes treats adults that require pediatric care.[20][21] Ann & Robert H. Lurie Children's Hospital of Chicago also features a state designated Level 1 Pediatric Trauma Center, 1 of 4 in the state.[22] The hospital has affiliations with the nearby Northwestern Memorial Hospital and adjacent to Prentice Women's Hospital. Lurie is located in the university's Streeterville campus with more than 1,665 physicians on its medical staff and 4,000 employees.[23]
The Shirley Ryan AbilityLab, formerly the Rehabilitation Institute of Chicago (RIC), is a nationally ranked physical medicine and rehabilitation research hospital based in Chicago, Illinois. Founded in 1954, the AbilityLab is designed for patient care, education, and research in physical medicine and rehabilitation. The AbilityLab specializes in rehabilitation for adults and children with the most severe, complex conditions ranging from traumatic brain and spinal cord injury to stroke, amputation and cancer-related impairment.[24] Affiliated with Northwestern University, the hospital is located on the Northwestern Memorial Hospital campus and partners on research and medical efforts.[25]
Prentice Women's Hospital is an acute care women's hospital located adjacent to both Northwestern Memorial and the Lurie Children's Hospital. Prentice Women's Hospital is a member of Northwestern Medicine and serves as a teaching hospital for the Northwestern UniversityFeinberg School of Medicine. The hospital provides tertiary-level obstetric, gynecological, and neonatal care to patients from the entire region. The hospital has 256 beds, with 86 AAP verified level III neonatal intensive care unit beds, 32 labor and delivery beds, 86 healthy bassinets, and 10 operating rooms.[26] The hospital is directly attached to the Lurie Children's Hospital via skybridge because Lurie physicians provide care on Prentice's neonatal intensive care units.[27]
NIH Mark O. Hatfield Clinical Research Center, Bethesda, Maryland
The National Institutes of Health (NIH) are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research.
Johns Hopkins Children's Center (JHCC) is a nationally ranked, pediatric acute care children'steaching hospital located in Baltimore, Maryland, adjacent to Johns Hopkins Hospital. The hospital has 196 pediatric beds[37] and is affiliated the Johns Hopkins School of Medicine.[38] The hospital is the flagship pediatric member of Johns Hopkins Medicine and is 1 of 2 children's hospital in the network. The hospital provides comprehensive pediatric specialties and subspecialties to infants, children, teens, and young adults aged 0–21[39][40][41] throughout Baltimore and the wider United States. Johns Hopkins Children's Center also sometimes treats adults that require pediatric care.[42] Johns Hopkins Children's Center also features one of the only ACS verified Level 1 Pediatric Trauma Centers in the state.[43] The hospital is directly attached to Johns Hopkins Hospital and is situated near the Ronald McDonald House of Maryland.[44]
The hospital has 1,051 beds and admits over 45,000 patients each year. The surgical staff performs over 34,000 operations yearly and hospital handles over 1 million outpatients each year at its main campus, as well as its six satellite facilities in Boston at Back Bay, Charlestown, Chelsea, Everett, Revere, and Waltham. In 2003, MGH was named the state's first Magnet hospital by the American Nurses Credentialing Center, a subsidiary of the American Nurses Association. As of 2020–21, MGH was ranked the #6 hospital in the United States by U.S. News & World Report.[34]
Michigan
University of Michigan Medical Center
Michigan Medicine,[45] formerly the University of Michigan Health System (UMHS), is the wholly owned academic medical center of the University of Michigan, in Ann Arbor. It includes the U-M Medical School, with its faculty group practice and many research laboratories; the U-M hospitals and health centers, which include the University of Michigan Hospital, C.S. Mott Children's Hospital, Von Voigtlander Women's Hospital, as well as approximately 40 health centers and home care services across southeast Michigan; the clinical programs of the U-M School of Nursing; and the activities of the Michigan Health Corporation, through which U-M partners with other medical centers and hospitals to provide specialized care throughout Michigan.
C.S. Mott Children's Hospital is a pediatric acute care hospital located in Ann Arbor, Michigan. The hospital has 244 pediatric beds[46] and is affiliated with the University of Michigan Medical School.[47] The hospital provides comprehensive pediatric specialties and subspecialties to infants, children, teens, and young adults 0-21[48][49][50] throughout Michigan and the surrounding states. The hospital sometimes also treats older adults that require pediatric care.[51] C.S. Mott Children's Hospital also features a Level 1 Pediatric Trauma Center, 1 of 3 in the state.[52] Attached to the children's hospital is the Von Voigtlander Women's Hospital that provides maternal and gynecological care for women.
Minnesota
Mayo Clinic
The Gonda Building, one of the many Mayo Clinic buildings at the main campus in Rochester
Mayo Clinic pays medical doctors a fixed salary that is unaffected by patient volume.[53] This practice is thought to decrease the monetary motivation to see patients in large numbers and increase the incentive to spend more time with individuals. Salaries are determined instead by the marketplace salaries for physicians in comparable large group practices.
The Mayo Clinic campuses in Rochester form the largest integrated medical center in the world.[54]
The medical campus generates an annual economic impact of nearly $6.3 billion for the St. Louis region with over 21,000 employees, the combined medical campus institutions are among the largest employers in the St. Louis metropolitan area.[55]
New York-Presbyterian Hospital, chartered as "The New York and Presbyterian Hospital" by New York State in 1996, was formed in 1998 with the merger of two large, previously independent hospitals, the New York Hospital and Presbyterian Hospital. The NYPH system includes a variety of outlying hospitals that had previously been acquired by NYH or Presbyterian; these hospitals stretch throughout the five boroughs, Westchester County, Long Island and New Jersey. NYPH is now the largest private employer in New York City.
The two medical schools remain essentially autonomous, though there is increasing cooperation and coordination of clinical, research, and residency training programs. NewYork-Presbyterian Hospital is one of the most comprehensive university hospitals in the world, with leading specialists in every field of medicine.
NYU Langone Medical Center is an academic medical center located in New York City, New York, United States, affiliated with New York University. The Medical Center comprises the NYU School of Medicine and several hospitals: Tisch Hospital, the Rusk Institute of Rehabilitation Medicine, the Hospital for Joint Diseases, NYU Langone Hospital—Brooklyn, NYU Winthrop Hospital,[56] and most recently, Hassenfeld Children's Hospital.[57] NYU Langone Medical Center also operates over thirty ambulatory facilities in Manhattan, Brooklyn, Queens and Long Island.[58] In early 2016, NYU Langone had approximately 25,000 employees,[59] and over 8,000 more employees were gained after the acquisition of Long Island's Winthrop-University Hospital.[56][60] The main campus of NYU Langone Medical Center overlooks the East River.[61]
Hassenfeld Children's Hospital (HCH) at NYU Langone (formerly Children's Health at NYU Hospitals Center) is a pediatric acute-care children's hospital located on the NYU Medical Center campus in Manhattan, New York. Hassenfeld Children's Hospital has 102 pediatric beds and is located in the Helen L. and Martin S. Kimmel Pavilion.[62] It is directly affiliated with the pediatrics department of the New York University Grossman School of Medicine. The hospital treats infants, children, teens, and young adults aged 0–21,[63][64] with some programs treating up until age 25.[65] While not a trauma center, Hassenfeld Children's Hospital contains the KiDS Emergency Department to treat children with injuries.
URMC is one of the largest facilities for medical treatment and research in Upstate New York and includes a regional Prenatal Center, Trauma Center, Burn Center, James P. Wilmot Cancer Center, an Epilepsy Center, Psychiatric/Behavioral Health Emergency and treatment departments, Liver Transplant Center and Cardiac Transplant Center and also includes a major AIDS Treatment Center and an NIH-designated AIDS Vaccine Evaluation Unit. A large portion of the university's biomedical research is conducted in the Arthur Kornberg Medical Research Building and the Aab Institute of Biomedical Sciences.
In January 2008, the University of Rochester announced a $500 million strategic plan geared toward expansion in research and patient services.[66] The plan anticipated adding 1,800 new jobs to the university, building a 123-bed addition to the hospital, a building for clinical and translational sciences, and a new ambulatory surgery center.
There are seven clinical departments that offer surgery at Upstate University Hospital. Collectively, the hospital offers more surgeons, robotic instrumentation and specialty procedures than any other facility in Central New York, with the Department of Surgery providing the largest component. In addition, the past decade has seen the expansion of cancer surgical specialties at Upstate. The surgeons who treat cancer see patients through the Upstate Cancer Center, a newer facility which provides disease-specific, multidisciplinary care to patients with different types of cancer.[71]
North Carolina
Duke University Health System
Duke University Health System (also known as Duke Health) combines the Duke University School of Medicine, the Duke University School of Nursing, the Duke Clinic, and the member hospitals into a system of research, clinical care, and education. Hospitals include the Duke University Hospital, Duke Children's Hospital and Health Center, Duke Regional Hospital, and Duke Raleigh Hospital. Duke University Hospital is a 957-acute care bed academic tertiary care facility located in Durham, North Carolina. Established in 1930, it is the flagship teaching hospital for the Duke University Health System, a network of physicians and hospitals serving Durham County and Wake County, North Carolina, and surrounding areas, as well as one of three Level I referral centers for the Research Triangle of North Carolina (the other two are UNC Hospitals in nearby Chapel Hill and WakeMed Raleigh in Raleigh).
UNC Health Care
UNC Medical Center (UNCMC) is a 905-bed[75]non-profit, public, research and academic medical center located in Chapel Hill, North Carolina, providing tertiary care for the Research Triangle, surrounding areas and North Carolina. The medical center is a part of the UNC Health Care Health System and is made up of four hospitals that include the North Carolina Memorial Hospital, North Carolina Children's Hospital, North Carolina Neurosciences Hospital, North Carolina Women's Hospital, and the North Carolina Cancer Hospital.[76][77] UNCMC is affiliated with the University of North Carolina School of Medicine.[78] UNCMC features an ACS designated adult and pediatric Level 1 Trauma Center[79][80] and has a helipad to handle medevac patients.[81][82]
North Carolina Children's Hospital (NCCH) is a pediatric acute care hospital located within UNC Medical Center in Chapel Hill, North Carolina. The hospital has 158 beds.[83] It is affiliated with The University of North Carolina School of Medicine, and is a member of UNC Health. The hospital provides comprehensive pediatric specialties and subspecialties to infants, children, teens, and young adults aged 0–21[84][85] throughout North Carolina. North Carolina Children's Hospital features the only pediatric Level 1 Trauma Center in the region, and 1 of 3 in the state.[80][86]
The Cleveland Clinic is a multispecialty academic medical center based in Cleveland, Ohio, although it has other locations. Currently regarded as one of the top hospitals in the United States,[34] the Cleveland Clinic was established in 1921 by four physicians for the purpose of providing patient care, research, and medical education in an ideal medical setting. One of the largest private medical centers in the world, the Cleveland Clinic saw more than 2,800,000 patient visits in 2005, with almost 70,000 hospital admissions.[87] Patients arrive at the Cleveland Clinic from all 50 states and more than 100 nations. The Cleveland Clinic's approximately 1,700 salaried staff physicians represent 120 medical specialties and subspecialties and is ranked among the top four hospitals in America.[34] The Cleveland Clinic has ranked number one in America for cardiac care for 15 years in a row.[88]
The Ohio State University Wexner Medical Center is a multidisciplinary academic medical center located in Columbus, Ohio, United States, on the main campus of The Ohio State University. In 2012, the Ohio State Medical Center changed its name to The Ohio State University Wexner Medical Center in honor of Ohio State alumnus and The Limited founder Les Wexner.[89] For 26 consecutive years, U.S. News & World Report has recognized Ohio State Wexner Medical Center specialties in its "Best Hospitals" rankings.
Entrance to Thomas Jefferson University Hospital on South 11th Street
Jefferson Health, is a multi-state non-profit health system whose flagship hospital is Thomas Jefferson University Hospital in Center City, Philadelphia. The health system's hospitals serve as the teaching hospitals of Thomas Jefferson University. Thomas Jefferson University and Jefferson Health are integrated together as two arms of the same organization. It has a single board of directors and produces joint financial statements. The CEO of Thomas Jefferson University and Jefferson Health is Joseph G. Cacchione, MD.
The original building of Pennsylvania Hospital, as seen from Pine Street in Philadelphia.
University of Pennsylvania Health System includes the nation's first teaching hospital, Hospital of the University of Pennsylvania (HUP), and the nation's first hospital, Pennsylvania Hospital. It operates under the direction and auspices of Penn Medicine in Philadelphia, Pennsylvania. HUP alone is ranked as the 9th-best overall hospital in the United States by U.S. News & World Report in 2010.[90] Although it is not a part of Penn Health System, the Children's Hospital of Philadelphia(CHOP) is also on the same campus and it engages in many collaborative efforts. CHOP's physicians serve as the pediatrics department of Penn's School of Medicine.
The University of Pittsburgh Medical Center (UPMC) is headquartered in Pittsburgh, Pennsylvania, and is closely affiliated with its academic partner, the University of Pittsburgh, which ranks third in the nation in the number of total NIH-sponsored research awards and fifth for the total dollar amount of NIH-sponsored funding.[91] UPMC is one of the largest medical center systems in the world with more than 35 hospitals, 8,000 licensed beds, and 600 outpatient sites in Pennsylvania, Ohio, and New York, as well as locations overseas. Appearing on U.S. News & World Report's honor roll of the top hospitals for over 15 years,[92] it was the site of the creation of the first polio vaccine by Jonas Salk, helped to develop emergency medicine under Peter Safar, and pioneered organ transplantation under the direction of Thomas Starzl, at one time boasting the largest and busiest organ transplantation program in the world.[93] A fully integrated health care system that includes its own health insurance and commercial services divisions, UPMC has exported its clinical and administrative expertise and technologies around the world, including the ISMETT organ transplantation center in Sicily, a hospital and cancer centers in Ireland, and partnerships in China, Colombia, Italy, Japan, Kazakhstan, Lithuania, Singapore, and the United Kingdom.[94]
The Texas Medical Center is the largest medical center in the world with one of the highest densities of clinical facilities for patient care, basic science, and translational research.[95] Located in Houston, the center contains 50 medicine-related institutions, including 21 hospitals and two specialty institutions, two medical schools, six nursing schools, and schools of dentistry, public health, pharmacy, and other health-related practices. All 50 institutions are not-for-profit and constitute some of the most highly regarded institutions in the country, including: M.D. Anderson Cancer Center, Texas Children's Hospital, The Texas Heart Institute, The Methodist Hospital and Baylor College of Medicine. The center is where one of the first and largest air ambulance services was created and where a successful inter-institutional transplant program was developed. More heart surgeries are performed at the Texas Medical Center than anywhere else in the world.[96]
Large academic medical centers have been criticized for their exorbitant cost. PwC has noted how "AMCs can do a lot of complex work, but 90 percent of patients are people who need to quit smoking, eat better, improve their literacy and find a better-paying job."[97][98]
^"What & Where We Practice". University of Michigan Medical School. January 10, 2017. Archived from the original on March 23, 2020. Retrieved March 23, 2020.
^Hill, UNC Hospitals 101 Manning Drive Chapel; Directions, NC 27514 Get Driving. "UNC Hospitals". www.uncmedicalcenter.org. Archived from the original on February 1, 2020. Retrieved February 1, 2020.{{cite web}}: CS1 maint: numeric names: authors list (link)
^"Patient Care". UNC School of Medicine. Archived from the original on February 2, 2020. Retrieved February 2, 2020.
^Hill, UNC Children's Primary Care Clinic 1512 E. Franklin St Suite 100 Chapel; Directions, NC 27514 Get Driving. "UNC Children's Primary Care Clinic". www.uncchildrens.org. Archived from the original on February 5, 2020. Retrieved February 5, 2020.{{cite web}}: CS1 maint: numeric names: authors list (link)
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