A Chancellor’s Tale: Transforming Academic Medicine

During his fifteen years as chancellor, Dr. Ralph Snyderman helped create new paradigms for academic medicine while guiding the Duke University Medical Center through periods of great challenge and transformation. Now, he has written a book chronicling his experience.

Dr. Ralph Snyderman's book is 336 pages and is available for purchase

Ralph Snyderman’s book is 336 pages and is available for purchase


Under his leadership, the medical center became internationally known for its innovations in medicine, including the creation of the Duke University Health System—which became a model for integrated health care delivery—and the development of personalized health care based on a rational and compassionate model of care. In A Chancellor’s Tale Snyderman reflects on his role in developing and instituting these changes.

Beginning his faculty career at Duke in 1972, Snyderman made major contributions to inflammation research while leading the Division of Rheumatology and Immunology. When he became chancellor in 1989, he learned that Duke’s medical center required bold new capabilities to survive the advent of managed care and HMOs. The need to change spurred creativity, but it also generated strong resistance.

Among his many achievements, Snyderman led ambitious institutional growth in research and clinical care, broadened clinical research and collaborations between academics and industry, and spurred the fields of integrative and personalized medicine. Snyderman describes how he immersed himself in all aspects of Duke’s medical enterprise as evidenced by his exercise in “following the sheet” from the patient’s room to the laundry facilities and back, which allowed him to meet staff throughout the hospital. Upon discovering that temperatures in the laundry facilities were over 110 degrees he had air conditioning installed. He also implemented programs to help employees gain needed skills to advance. Snyderman discusses the necessity for strategic planning, fund-raising, and media relations and the relationship between the medical center and Duke University. He concludes with advice for current and future academic medical center administrators.

The fascinating story of Snyderman’s career shines a bright light on the importance of leadership, organization, planning, and innovation in a medical and academic environment while highlighting the systemic changes in academic medicine and American health care over the last half century. A Chancellor’s Tale will be required reading for those interested in academic medicine, health care, administrative and leadership positions, and the history of Duke University.


“Dr. Snyderman has presented readers with a critical, reflective, personal, and at times painful account of his thirty-five-year tenure at Duke. He presents a perspective of Duke, and of a growing academic medical center, as honestly and frankly as possible, without being harsh. His candid reflections are refreshing, given most leaders’ tendencies to either sugarcoat the past or vilify those who have stood in their way. A Chancellor’s Tale provides invaluable insights into the workings of a large and respected U.S. academic medical center and into the mindset of one of its top leaders who steered the ship through rough seas and calm waters, raising Duke to its current national and international prestige.”E. Albert Reece, MD, Vice President for Medical Affairs, University of Maryland

“Compassionate physician, award-winning biomedical scientist, successful pharmaceutical executive, medical educator, and administrator, Ralph Snyderman’s remarkable and multifaceted career spans the full range of biomedicine. Here he describes in vivid detail how, as Chancellor, he transformed Duke University Medical Center into a powerhouse integrated health system while pioneering the innovative and widely emulated approach now known as prospective or personalized medicine.”Robert J. Lefkowitz, MD, Investigator, Howard Hughes Medical Institute, James B. Duke Professor of Medicine, Duke University

“Providing a unique perspective on the internal politics at Duke, Dr. Snyderman exposes many of the complexities and problems inherent in the governance of any academic medical center. A Chancellor’s Tale is also a story of what Dr. Snyderman witnessed through his eyes and ears and of his creative leadership. I admire him greatly for what he accomplished at Duke.”Michael M. E. Johns, MD, Interim Executive Vice President for Medical Affairs, University of Michigan

“Dr. Ralph Snyderman is a doctor’s doctor, the best of the best in American medicine. In A Chancellor’s Tale, he effectively synthesizes his extraordinary breadth of experiences into something more than the sum of its parts-a visionary, transformative view of what true health care can be at a time when it is most needed. If you only read one book on transforming health care this year, this is it. Highly recommended!” Dean Ornish, MD, Founder & President, Preventive Medicine Research Institute, Clinical Professor of Medicine, University of California, San Francisco

About The Author

Ralph Snyderman, MD, is Chancellor Emeritus, Duke University, James B. Duke Professor of Medicine, and Director of the Center for Research on Personalized Health Care at the Duke University School of Medicine. He previously served as Chancellor for Health Affairs at Duke University and as the founding President and CEO of the Duke University Health System; Dean of the School of Medicine at Duke University; Chair of the Association of American Medical Colleges; Senior Vice President, Medical Research and Development, Genentech, Inc.; Director, Laboratory of Immune Effector Function, Howard Hughes Medical Institute; Chief, Division of Rheumatology and Immunology at Duke; and Senior Investigator, National Institutes of Health. Dr. Snyderman has received numerous honors, including the Personalized Medicine World Conference Pioneer Award (2016), the North Carolina Life Sciences Leadership Award (2014), the Association of American Medical Colleges David E. Rogers Award (2012), the Industrial Research Institute Medalist Award (2008), the Ellis Island Medal of Honor (2003), and the CIBA-GEIGY Award for Lifetime Achievement in Inflammation Research (1992). He has authored almost 400 manuscripts and is the editor or coeditor of several books. Dr. Snyderman lives in Durham, North Carolina.

Watch Dr. Snyderman discuss his book below. For more information about the book, please visit Duke University Press’s website.