Disruptive Innovation October 24, 2012

1. Disruptive InnovationOctober 24, 2012 Dan Hunt, MD, MBA Senior Director, Accreditation Services Association of American Medical Colleges

2. Disruptive Innovations Hunt’s Regional Campus Pyramid

3. Regional Campus Evolution Curriculum Forces Site of Training Academic Physicians University Salary Academic Medical Center/Hospital Educational Program Located in Basic Science Accreditation/Licensing

4. Involvement Outside of theAcademic Center Curriculum Forces Site of Training Academic Physicians Ambulatory Clinic University Salary Academic Medical Center/Hospital Educational Program Community Physicians Located in Basic Science Family Medicine Ambulatory Clinic Accreditation/Licensing

5. Community Physician Input Curriculum Forces Site of Training Clerkship Academic Physicians Clerkship Second Year Increase class size $ Educational Program Academic Medical Center/Hospital Community Physicians = Community Placement Basic Science Community Based Educators Clerkship Clerkship Accreditation/Licensing

6. Community Stakeholder Input Curriculum Forces Site of Training Integrated Third Year Academic Physicians Fourth Year Community Placement Community Stakeholders Increase class size $ First & Second Year Educational Program Community Physicians = Academic Center/Hospital Basic Science Community Based Educators Accreditation/Licensing

7. Disruptive Innovations The Regional Campus Pyramid “Stifling innovation”, no input on committees, sharing tuition, “face” in community

8. The Regional Campus Pyramid Hiring the empire builder instead of the team player

9. The Regional Campus Pyramid No checks and balances across sites

10. The Regional Campus Pyramid Absence of clear decision making process over campus activities

11. Disruptive Innovations: Part 2Clay Christensen

12. Disruptive Mini-mill Steel Technology Sheet Steel Structural Steel Bars and Rods Profit Margin Rebar

13. Disruptive Mini-mill Steel Technology Sheet Steel Structural Steel Bars and Rods Profit Margin Rebar Quality of Mini Mill Steel

14. Disruptive Mini-mill Steel Technology Sheet Steel Structural Steel Bars and Rods Profit Margin Rebar Quality of Mini Mill Steel

15. Disruptive Mini-mill Steel Technology Sheet Steel Structural Steel Bars and Rods Profit Margin Rebar Quality of Mini Mill Steel

16. Disruptive Mini-mill Steel Technology Sheet Steel Structural Steel Bars and Rods Profit Margin Rebar Quality of Mini Mill Steel

17. 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

18. Migration of medical students into more advanced specialties Sub Specialty Tertiary Secondary Profit Margin Primary

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

20. So the Question is not “Should we use innovative curriculum?”…… It is “To what end do we use it?”