The polity of academic medicine: A critical analysis of autocratic governance

Steven J. Willing, Richard B. Gunderman, Philip L. Cochran, Todd Saxton

Research output: Contribution to journalArticle

1 Scopus citations


How should academic radiology departments be governed? This question has rarely been directly addressed in the radiology literature. The dominant model of administration in present-day academic departments differs from that typically seen in private group practices. Whereas private group practices tend to follow a democratic model whereby key decisions must be supported by a majority of the partners, in academic institutions, medical school deans and department chairs generally possess great latitude in strategic and operational decision making. This article considers arguments for and against "top-down" governance in academia. The rationale supporting this form of governance is weak, and the best evidence from the fields of management and organizational behavior suggests it may in fact be detrimental.

Original languageEnglish (US)
Pages (from-to)972-980
Number of pages9
JournalJournal of the American College of Radiology
Issue number12
StatePublished - Dec 2004


  • Academic medicine
  • Autocracy
  • Chair
  • Chairperson
  • Democracy
  • Governance
  • Practice management

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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