The story starts in 1992, when Dr. Meyer spent a sabbatical year at the Center for Advanced Study in the Behavioral Sciences at Stanford University. With the support of the MacArthur Foundation, he conducted a study on the impact on academic psychiatry of the profound economic changes affecting clinical practice, teaching, and research in our academic centers. His work was further informed by a distinguished advisory committee developed through the Association of Academic Health Centers, which also hosted the study. Like the fine researcher he is, Dr. Meyer posits the questions noted, designs his method and instruments, and journeys to many departments within the academic landscape. His report encompasses 1) the academic faculty, including the sources of their support, 2) the clinical service delivery systems, as they are now termed, within academic centers as they try to respond to managed care, 3) the past, present, and future educational missions of academic psychiatry, 4) the place of research in the mission of academic psychiatry, 5) psychiatry and primary care, and 6) academic psychiatry’s role in and effects on the system of care of the Department of Veterans Affairs and veterans. Although the book is an edited text, all of the chapters but one are written by the editors.