Plenty of other research ventures to pick up the slack. Baylor's #1 in pediatrics, urology, micro/immuno... I know there was one or two more. Can't remember off the top of my head. They're top 5, top 10, top 25 in other areas (biochem and neurosci and ENT come to mind off the top of my head) as well.
One thing that really surprises me is that they (apparently) haven't exploited Menninger yet. They have one of the top psychiatric hospitals - this from my dad the shrink and his partners - perhaps Menninger isn't into research?
The reason this NIH stuff worries me is twofold:
1)Research ranking begets reputation. If Baylor starts falling, its reputation will fall. If Baylor maintains its top 5-top 10 NIH tables position, its reputation will be stable or possibly rise.
2)Dr. Traber is making a lot of changes. They've reduced the strength of a 50 year partnership, strengthened an affiliation with another hospital that is still affiliated with another medical school, and made plans to build a Baylor clinic. That's a lot of upheaval in the conservative, relatively stable world of medicine; if the Baylor Clinic turns out to be huge, great, it's always great to have the medical school's name on the institution. But it also exposes the school to more financial risk. The affiliation game is a more financially protected position to work from, which is probably why you'll never see Harvard University Hospital get built (even though they could afford it many times over). As for Methodist and St. Luke's - you have to wonder why they couldn't work out some kind of dual primary adult training center thing out. St. Luke's has strengths, Methodist has strengths, and except for heart, they don't really overlap (and even there, THI >> Methodist).
This just makes me wonder if this is a blip that, as you wisely pointed out, is just reflective of one year's data and could be influenced by a whole bunch of factors, such as renewals et al., or if this is a sign that Baylor is focusing too much on TMC politics and not enough on what should really be occupying their interest, namely increasing their research funding (and, obviously, our education - but I think a medical school's curriculum usually does well under salutary neglect). That said, that Dr. Traber was part of turning the Hosp. of UPenn around DOES give me a lot of confidence that he'll make the clinic work.