The organizational structure of the academic health center (AHC) may present significant barriers to deep and lasting organizational change. The insular nature and structure often seen in academic departments and other units at AHCs result in competition for scarce resources, rather than in working together to add value to one another or to the organization as a whole. Successful unification around organizational performance goals is needed more than ever by AHCs as they struggle to meet their challenges. Over a five-year period (2000-2005) at the Penn State College of Medicine and Milton S. Hershey Medical Center, organizational inner cohesiveness was created through the use of teams that unified the clinical, academic, and research enterprises. Barriers that typically separate academic departments, such as a lack of understanding of the impact of organizational funds flow on each of the missions, were broken down. Traditional barriers between employees and management (e.g., poor communication, lack of clarity on organizational goals, and claims that neither side understood the other) were reduced. Problems that seemed to be intractable in the past such as an inequitable distribution of resources, responsibilities, and rewards, were solved through the implementation of a teams approach across departments and missions. The authors describe the creation and operation of these AHC-wide teams. The rationale for using teams is elucidated, the difference between teams and committees is defined, and data on five years of team performance are presented. The authors argue that the breadth of scope and comprehensiveness of the teams approach represents an effective model for implementing AHC-wide transformational change.