Barnes-Jewish Hospital

Challenges posed by managed care, cuts in government spending and other factors led to new affiliations and mergers in the 1990s. In 1992, Barnes formalized its affiliation agreement with the Jewish Hospital of St. Louis. In 1993, the two hospitals joined with Christian Health Services to form BJC Health Systems -- the first healthcare system in the country to integrate academically based hospitals and a system of community hospitals serving a broad urban, suburban and rural area.

In January 1996, Barnes and Jewish Hospitals merged to form Barnes-Jewish Hospital. The merger built on the original affiliation by combining all of the attributes of the hospitals into a single organization led by on board of directors and one management team.

In the meantime, the medical advances continued. Dr. Ralph Clayman performed the nation's first laparoscopic nephrectomy -- removal of a kidney through minimally invasive technique -- in 1990. Dr. Susan E. Mackinnon performed the country's first nerve transplant on a 12-year-old Indiana boy in 1993. And Dr. Todd Howard, Dr. Jeffrey Lowell and Dr. Surendra Shenoy performed the country's first adult liver transplant using a living donor unrelated to the recipient in 1996, shortly after the Barnes-Jewish merger.