The authors describe the events and restructuring efforts of the 1990s that led the University of Minnesota Medical School leadership to advocate a new administrative model for its clinical departments. This new streamlined model established six administrative centers, each serving a cluster of two to four clinical departments. Each administrative center was charged with managing functions of finance, human resources, information technology, clinical service unit operations, research support, and education support for its departments.These centers, first proposed in 1993 when an outside firm analyzed the medical school's administration, were initially seen by most medical school department heads as too radical. Yet, after a campaign of one-on-one persuasion by medical school dean's office leadership, combined with a successful example of clustering that occurred spontaneously among three medical school departments, the administrative centers were launched in late 1998 to serve clustered clinical departments. The administrative centers were intended to improve departmental responsiveness to the dean of the medical school; improve internal medical school controls; improve on administrative services traditionally provided by outside units, such as grants management and information systems; and reduce administrative costs. Since their establishment, these administrative centers have evolved into a flexible, efficient system of administration.In a 2005 evaluation, ECG Management Consultants found the administrative center model appropriate and effective in managing the school's clinical departments. In addition, the consultants estimated that if the medical school still had stand-alone departmental administrative units, annual administrative costs would be $3 million higher.