I endorse Lawrence D. Brown's thesis that “misplaced concreteness” is a fallacy that “lay[s] at the doorstep of a particular type of organization problems that are properly ascribed to . . . the historical, cultural, and political forces that produce public policy.” I also agree that academic medical centers (AMCs) exemplify the fallacy. Brown writes, “That AMCs should summon a stronger voice for policies of social protection is hard to deny . . . [but] their preoccupation with a core curative mission powerfully discourages such policies.” In what follows, I augment his analysis by summarizing some of what I have learned from studying and writing about AMCs and helping to govern and administer one of them (Fox 1980, 1986a, 1986b, 1996, 2001, 2015).
What Brown calls the “core curative mission” of AMCs emerged in the late nineteenth and early twentieth centuries, initially in Germany,...
