Duke Medicine is, by all metrics, a major biomedical research center, so this is a quite dramatic move, coming at a time when, of course, NIH grants are much harder to get due to the Trumpistas.  If this doesn't produce a revolt and exodus at Duke, expect this practice to spread.

(Thanks to Owen Flanagan for the pointer.)

UPDATE:  Longtime reader Dr. Roger Albin, who teaches at the University of Michigan Medical School, writes:

The announced Duke Med School policy is definitely significant but is likely to have a smaller impact than most would think.  This policy will primarily affect PhDs in basic science departments. These faculty, however, are a relatively small fraction of the faculty at any major academic medical center. Most Med School faculty are physicians who have alternative ways of covering their salaries.  This includes physician-scientists like me. If we lose our grant support, we’re expected to compensate via clinical practice. In a typically perverse way, this is often financially advantageous for clinical departments. NIH rules cap the amount of salary that an investigator can draw from a grant. This cap is usually lower than the salaries for physicians. In many, many cases, physician-scientist salaries have to be subsidized by their departments, and such subsidies can be very costly.  Academic medical centers are facing/going to face additional financial pressures beyond what is highly likely to be reduced NIH funding, so these kinds of policy responses are going to be increasingly common. Duke isn’t the first institution to try a policy like this one (https://www.aaup.org/news/good-decision-tenure-rights-tufts-med-school-case), and I think that there is some litigation involving other institutions.