Pros and Cons of Academic Hospital Care

Academic medical centers are those universities that teach medical students and include an affiliated hospital, called a teaching hospital, which provides hands-on experience to further those students' educations. These institutions may call themselves university health systems, or academic medical centers, or any combination of those words.

It's usually easy to pick out which hospitals are teaching hospitals because they most often have the word "university" in the name of the hospital. There will be a University of ____ (fill in the name of the university, state or city) hospital or it will just be called "University Hospital." According to the American Association of Medical Colleges, as of early 2012, there were 136 accredited academic medical schools in the United States and 17 in Canada, representing 400 teaching hospitals and health systems, and 62 VA (Veterans Affairs) hospitals.

Who Can Be Helped at an Academic or University Medical Center?

While anyone can be admitted and treated at an academic medical or teaching hospital, there are certain patient profiles who might benefit by choosing doctors who are affiliated with these academic medical centers and teaching hospitals, as follows:

  • If you use Medicaid or a combination of Medicaid and Medicare you may find yourself welcome at university-affiliated hospitals. Often these hospitals are located in urban areas. They are considered to be "safety net" hospitals, and will admit patients who cannot afford private insurance, but have health coverage from a government program. (Note—that does not mean university hospitals don't accept other patients—they do.)
  • If you have an unusual diagnosis or a rare disease you may find extended help in an academic medical setting because the doctors affiliated with university hospitals are often those who are also interested or involved in research, and therefore may enjoy going beyond the day-to-day of non-academic medicine. Further, there are student doctors in teaching hospitals who are learning everything they can about medicine, and sometimes unusual diagnoses are ​a great deal of interest to them. Their university affiliation may also mean they must meet requirements to publish papers, journal articles or books, and unusual diagnoses may provide good topics for publication.
  • If you can't get a diagnosis you may also find extended help from doctors and students who work in academic medical systems, for the same reasons as those who have unusual diagnoses and rare diseases might.
  • Children who have difficult childhood diseases may find the help they need from teaching hospitals which often have a children's hospital affiliated with them too.
  • Patients who live in rural regions may find that their smaller, local hospitals are affiliated with the larger, regional, academic system. Sometimes this extended help will be managed through telemedicine. For example, a patient who suffers a stroke may be taken by ambulance to a small community hospital, but her treatment may be overseen by a neurologist at an academic medical center in a larger city in the region.

Pros: Why an Academic or Teaching Hospital May Be a Good Choice

doctor and nurse talking and looking at digital tablet in hospital hallway
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There are some definite pros and cons to working with doctors who are affiliated with these teaching centers and hospitals. Here are some pros for you to consider:

  • Salaried doctors: While most doctors in private practice, and those affiliated with non-teaching hospitals, are reimbursed by insurance based on how many patients they see, or tests or procedures they offer, doctors who work at academic medical centers and teaching hospitals are usually paid on salary. That means the emphasis isn't necessarily on seeing too many patients in too short a time (although in some academic institutions it is.) Since there may be less emphasis on herding large numbers of patients through, or ordering tests or procedures, those doctors may be able to take some extra time with you.
  • Research and clinical trials: The professionals who work in academic medical centers are often interested in research too. They are the people who run clinical trials, or who are on the lookout for new ideas. In particular, when you have a rare disease or undiagnosed symptoms, these extended interests may provide answers that won't be forthcoming from a doctor in private practice.
  • Centers of excellence: Academic medical systems and teaching hospitals often build "centers of excellence" which focus on certain diseases or conditions, like stroke centers, heart centers, cancer centers, and others. They will group the doctors and support staff needed for these specialty centers into focused teams.
  • Access to treatments: Because of the ways licensing works, there are sometimes treatments available through academic medical institutions that may not be available through private practices.
  • Academic departments: Academic medical centers often offer services that are related to academics and are therefore not found in other hospitals. For example, there may be an ethics department that can be called upon to consult with families who may have very difficult decisions to make.

Cons: Why an Academic or Teaching Hospital May Not Be the Place for You

Here are some of the reasons you might want to avoid being admitted to a university teaching hospital:

  • Student doctors at work: One of the biggest complaints patients voice about seeking healthcare in an academic medical hospital is the fact that student doctors play an important role in the care they receive. Teaching hospitals are where you'll find residents—doctors who have earned the academic right to use the title doctor but aren't yet licensed, experienced doctors. Yes, they have to learn somewhere, and sometimes they can be even better communicators than the full-fledged attending physicians. But remember, they are students just the same. Most of these academic teaching hospitals will provide an informed consent document that is flexible enough that you can exclude residents or other student doctors from providing your care. Just be sure you read the document closely enough and ask enough questions before you sign it to make sure you get the care you want from the people you want to get it from.
  • Modesty issues: If you have modesty issues, you may find it's more difficult to control who takes care of you in a teaching hospital. With a ratio of approximately 50-50 male to female student doctors, you will have less of an opportunity to limit those who will take care of you to one gender or the other.
  • Dangerous times: One of the well-known and documented problem areas of an academic institution is related to the academic calendar. Studies have shown that it can be dangerous to be admitted to a university or teaching hospital in July because that's when the newest doctors have just started working in the hospital. Avoiding a teaching hospital in the months of July or August can be life-saving.

Making Your Best Decision about an Academic Hospital

Once you have considered the patient profiles and the pros and cons of seeking care from an academic medical center, and if you think an academic medical system might help you find the help or answers you need, then contact that hospital or center and make an appointment.

If you aren't sure whether there is a university medical system near you, then you can find the closest one.

If those cons have given you pause, and you don't believe a university teaching hospital or center is a good choice, then consider other ways to choose the right hospital for you.

By Trisha Torrey
 Trisha Torrey is a patient empowerment and advocacy consultant. She has written several books about patient advocacy and how to best navigate the healthcare system.