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The birth of the Duke University Health System (DUHS) is perhaps the marquee achievement of Dr. Snyderman’s 15-year tenure. As the system of referrals to Duke University Hospital specialists came undone as a consequence of managed care, Dr. Snyderman recognized that a new “hub and spoke” system had to entail expansion. The effort to integrate Durham Regional Hospital into the Duke system became key to creating DUHS. It was a protracted and many-sided challenge, a challenge eventually overcome and turned into a great and ongoing success and integration of Duke with the communities it serves.

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