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But even from the earliest days of the endowment, the trustees and staff did not fund hospitals qua hospitals, but rather hospitals as a means to the object of good medical service. The Duke Endowments workincluding funding the first group health plan in the Carolinas and putting the states ahead of the curve in outpatient careultimately raised standards of medical care in the Carolinas

The district court quashed both subpoenas, an action later affirmed by the D.C