Let's face facts: even though folks who read this magazine presumably hold the research process in high regard, the phrase "academic research hospital" probably doesn't sound as exciting as, say, the mow-down spirit of Wall Street or the Tyson-Holyfield match. But think again. In today's free-for-all health-care market, academic hospitals-which conduct the research that undergirds high-tech medicine, educate new doctors about the latest techniques, and apply those tools and methods to rich and poor patients alike-are battling to maintain their financial strength in the face of competition from for-profit hospitals. Exciting?

"A little too exciting," says Samuel O. Thier, president and chief executive officer of Partners HealthCare System. That nonprofit Boston-based organization includes two of the largest and most respected teaching hospitals in the country, Massachusetts General and the Brigham and Women's, as well as three other teaching hospitals and a network of more than 750 separate primary-care doctors. "You have to remember that this isn't a game; we're talking about health care for people."