At the end of his article on the difficult times facing academic medical centers ("Unhealthy Hospitals," March-April, page 29), David Blumenthal said that the nation’s universities "might never have entered the medical business if they had known what lay in store." A presumably apocryphal story is applicable: In a hallway somewhere at the Council on Higher Education hang portraits of all the Ivy League presidents. The only one who is smiling is the president of Princeton, and the reason is that Princeton is the only Ivy League university that does not have a medical school.