This situation is further exacerbated by the flight of physicians, in order to protect their livelihood, to large umbrella organizations (including universities) to which they now must provide or express some allegiance and conformity. In the face of these challenges, the independence and autonomy of the medical community are threatened, especially that of Academic Health Centers. Physicians face many significant challenges in these times of new laws and regulations, new institutional alignments and consolidations, government oversight, and scarce resources (especially in regard to reimbursement and research).
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