Ralph Snyderman, MD, is Chancellor Emeritus, Duke University, James B. Duke Professor of Medicine, and Director of the Center for Research in Personalized Health Care at the Duke University School of Medicine. He previously served as Chancellor for Health Affairs at Duke University and as the founding President and CEO of the Duke University Health System; Dean of the School of Medicine at Duke University; Chair of the Association of American Medical Colleges; Senior Vice President, Medical Research and Development, Genentech, Inc.; Director, Laboratory of Immune Effector Function, Howard Hughes Medical Institute; Chief, Division of Rheumatology and Immunology at Duke; and Senior Investigator, National Institutes of Health. Dr. Snyderman has received numerous honors, including the Personalized Medicine World Conference Pioneer Award (2016), the North Carolina Life Sciences Leadership Award (2014), the Association of American Medical Colleges David E. Rogers Award (2012), the Industr
Evolution of the Duke University Medical Center
The Duke University Medical Center when Ralph Snyderman took over as Chancellor of Health Affairs in 1989 was a well-recognized academic medical center, a sprawling, complex, and large academic, clinical, and educational institution. But, like similar institutions with the development of managed care, it faced a challenge to its longstanding organization and business model wherein margins earned from clinical activities subvented other essential aspects of the institution. As clinical margins declined, fundamental adjustments to the departmentally based organizational structure became imperative. A more centralized management and budgeting system was needed and this in turn created tumult and resistance among some constituencies reluctant to part with traditional ways.