disruptive innovation october 24, 2012

Disruptive Innovation

October 24, 2012

Dan Hunt, MD, MBASenior Director, Accreditation Services

Association of American Medical Colleges

Disruptive Innovations Hunt’s Regional Campus Pyramid

Governance

Policy

Personnel

Respect

Curriculum Forces Site of Training

EducationalProgram

Basic Science

University Salary

Located

in

Academic MedicalCenter/Hospital

Regional Campus Evolution

Academic Physicians

Accreditation/Licensing

Located in

Involvement Outside of theAcademic Center

Ambulatory Clinic

Family Medicine

Curriculum Forces Site of Training

EducationalProgram

Basic Science

University Salary

Academic Physicians

Accreditation/Licensing

Ambulatory Clinic

Community Physicians

Academic MedicalCenter/Hospital

Increase class size $

=

Community Physician Input

CommunityPhysicians

Academic MedicalCenter/Hospital

Clerkship

Second Year

CommunityPlacement

ClerkshipClerkship

Curriculum Forces

EducationalProgram

Basic Science

Academic Physicians

Accreditation/Licensing

Site of Training

Clerkship

Community Based

Educators

=

Community Stakeholder Input

Community Placement

Integrated Third Year

First & Second

Year

Increase class size $

CommunityPhysicians

Curriculum Forces

EducationalProgram

Basic Science

Academic Physicians

Accreditation/Licensing

Community

Stakeh

olders

Site of Training

AcademicCenter/Hospital

Fourth Year

Community Based Educators

Disruptive Innovations The Regional Campus Pyramid

Governance

Policy

Personnel

Respect

“Stifling innovation”, no input on committees, sharing tuition, “face” in community

The Regional Campus Pyramid

Governance

Policy

Personnel

Respect

Hiring the empire builder instead of the team player

The Regional Campus Pyramid

Governance

Policy

Personnel

Respect

No checks and balances across sites

The Regional Campus Pyramid

Governance

Policy

Personnel

Respect

Absence of clear decision making process over campus activities

Disruptive Innovations: Part 2Clay Christensen

Disruptive Mini-mill Steel Technology

Rebar

Bars and Rods

Structural Steel

Sheet Steel

Profi

t Mar

gin

Disruptive Mini-mill Steel Technology

Rebar

Bars and Rods

Structural Steel

Sheet Steel

Profi

t Mar

gin

Quality of Mini Mill Steel

Disruptive Mini-mill Steel Technology

Rebar

Bars and Rods

Structural Steel

Sheet Steel

Profi

t Mar

gin

Quality of Mini Mill Steel

Disruptive Mini-mill Steel Technology

Rebar

Bars and Rods

Structural Steel

Sheet Steel

Profi

t Mar

gin

Quality of Mini Mill Steel

Disruptive Mini-mill Steel Technology

Rebar

Bars and Rods

Structural Steel

Sheet Steel

Profi

t Mar

gin

Quality of Mini Mill Steel

Up-market Drift Creates a Vacuum

• Expedited when “customers” are migrating up• Expedited when up-market means better profit

margins• Difficult to reduce costs and create a less

expensive product by the “successful” industry

Nature abhors a vacuum and will find a way to fill it

Migration of medical students into more advanced specialties

Primary

Secondary

Tertiary

Sub Specialty

Profi

t Mar

gin

"When Nurses want to be called Doctor”New York Times 11/2/2011

So the Question is not “Should we use innovative curriculum?”……

It is “To what end do we use it?”