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Like many academic facilities across the country, Carolinas Medical Center (CMC), an academic medical center affiliated with Carolinas HealthCare System in Charlotte, NC, has faced pressures in recent years to increase clinical production in order to thrive in a tightening financial environment. However, when CMC revamped its system in 2004, its leaders did not want the focus on clinical production to completely overshadow the research and education components of physicians' workload.