getty_488822687_9709709704500209_50148In the Biblical parable, God commands Jonah to make a journey to a foreign land and preach against the wicked. Instead Jonah sets sail in the opposite direction believing that the unrighteous were unworthy of salvation. The almighty raises a storm and the crew sacrifices Jonah by casting him into the turbulent sea where he is swallowed whole by a great fish or whale. Penitent, Jonah is expelled from the leviathan and washed ashore so that he may travel to the land of the wicked where they are moved by his words to repent and are thus saved. (more…)


Smart people can make bad innovators. The brilliant thinkers at the top of their field are often the individuals least willing to take the risks required to implement deep change. Innovation is a highly iterative process based on trial and error. When we’re moving toward the uncertainty of the future, the only way to find the best solution is to learn from our mistakes. For this reason, failure is not only inevitable–it is necessary. This is something the smartest people around just can’t bring themselves to do: go through the failure cycles. Because they’re convinced of their own apparently effortless superiority, the greatest intellects often believe that they simply don’t have to experience the failure cycle the way everyone else does.

This is the beguiling paradox I encountered when I was called on to develop and implement an innovation process to help improve the quality and efficiency of patient care at a leading university medical center: the most gifted, experienced surgeons were also the least open to implementing change. In fact, the rock-star surgeons were reluctant to acknowledge that there even was a problem to be fixed. This was in the early 1990s, when insurance companies paid whatever the medical centers charged, but that was quickly changing. However, in the surgeons’ small world, all they saw was that the operating room timeslots were consistently filled and everything was perfect except finding a last minute parking spot for their luxury cars. To them, there was no reason to innovate in the first place. They didn’t understand that emerging technologies were making it possible to dramatically increase the speed and effectiveness of medical care, and insurance companies were leading the change.

So when I came into the picture, the surgeons didn’t want to hear what I had to say. The way they saw it, even though I had experience leading innovation, I didn’t have sufficient background in medical practice or research and had no business advising top medical professionals what to do.

I decided to engage an outside expert, a brilliant physician with both an M.D. and Ph.D., and extensive experience in medical innovation, in order to increase my own understanding the situation, develop a viable strategy and most importantly improve my standing with the prominent medical faculty. After a month of extensive evaluation, we both concluded that the medical center needed more than just an innovation process, it needed a partner to be sustainable. So we started merger talks with the CEO of the other leading medical center in the region.

Recruiting this outside specialist didn’t get me any more support from the still-skeptical surgeons, who remained set in their old ways. I even brought in extensive data from various studies conducted on medical efficiency to emphasize why these innovations were so important, and the surgeons dismissed the information as ungrounded and irrelevant.

Then, in a move that I was convinced would finally bring the surgeons to my side, I took them to visit another medical facility, where innovations had greatly improved all aspects of patient care, so they could see first-hand what could be done. Whereas the average cardiovascular surgery at our hospital took 20 days in the step-down unit before the patient was discharged, the same procedure at this other hospital took only 4 days.

And yet the surgeons refused to see the light. They came up with far-fetched explanations and excuses as to why their procedure took so much longer: existing rules and regulations that they supposedly couldn’t get around, differences in climate, less healthy and older patients.

Nine months into this project, I was at a standstill. Then one day, I learned that one of the most well-respected–and notoriously out-spoken–of the surgeons had something in common with me: we both graduated from the same university. I told him about our shared alma matter, and this became a starting point for a real conversation. I asked him honestly what he thought we should be doing with our plan for change. I asked him for his input and, through our talks, I enrolled him as a supporter of the initiative. He went from being our most vocal critic to our most ardent evangelist–all because I made what was once my innovation his innovation. By transferring the ownership to him, I helped turn his reactive position into a proactive one.

Soon after our breakthrough conversation, this senior surgeon enrolled his colleagues and the junior doctors who all looked up to him. With this new base of support, the project very quickly gained momentum. Nearly 120 days later, we saw big results: the 20-day patient turnaround average turned into an 8-day average with improved patient recovery rates.

Amidst all this advancement, the two CEOs involved in the merger sued each other. The news came as a shock to me: what I initially took to be an issue of using innovation to improve efficiency and quality of care had turned into a power struggle over who would be king. But this proved to be the unavoidable pattern of medical mergers in the coming years: these unions were powerful but short-lived, coming one after the other, not unlike someone on their fifth marriage. So this wasn’t a source of discouragement–it was merely the reality of the industry and the way growth took form.

The biggest challenge was enlisting the support of my harshest critics–the surgeons themselves. It wasn’t until we established our rapport and trust that we achieved the momentum that led to big change. With every important innovation comes resistance. The more meaningful the innovation, the more resistance you’ll meet. And if you don’t encounter any resistance, then you’re likely doing it wrong: you need to take more risks and increase the speed and magnitude of your project. The wonder of it all is that your most relentless adversary just might turn out to be your greatest ally.


o-SCHOOL-facebookAccording the Chronicle of Higher Education and National Public Radio, competency based education is the new thing. Actually, it’s the old thing. Vocational education, once the main road to middle class prosperity in America, has returned with a new name and an updated version of the same approach: see one, do one, teach one. Electricians, plumbers and even physicians are all still apprenticed and routinely evaluated to gauge their level of skill and expertise.

John Dewey, the great American philosopher and leading prognosticator of a school of thought we now call pragmatism built schools and universities at the turn the Nineteenth Century that influenced the entire American educational system to become more practical, applicable and measurable. This functional approach to education worked so well that the United States innovated its way past more established nations in less than a century.

So if competency based education is such a great idea, why did we return to the more general and rarified curriculum and pedagogy of a liberal arts approach? Because higher education is not just about the acquisition of skills. It has become the central socializing system in a post-industrial economy and the dynamic exchange where new ideas are created and shared, or bought and sold, depending on your point of view.

The campus has become the breeding grounds for innovators and the cradle for their progeny. Pick any major research university in the western world and observe the prosperous amalgamation of businesses and institutions nicely situated across the street. They vigilantly stand watch for the next new thing. It turns out that knowledge isn’t just power: it’s money as well.

A recent cover story of the Economist, America’s New Aristocracy, points out that our most prestigious universities are getting ever more selective. Anyone who was lucky enough to go to a top tier institution quietly wonders if they would in fact be admitted to their alma mater today. A liberal arts degree from an elite school has come to mean so much more than the development of any number of competencies. It has become a premium brand: something valuable and rare. It suggests status and gives entre to those talented few who can speak the arcane languages of medicine, law, physics and finance. It’s little wonder that studies on social immobilitynicely correlate to the astonishing rise in the cost of a quality college education. It’s among the best of all possible investments if you can afford it. There’s the real rub and reason behind the push for new approach to higher education.

Thomas Edison, arguably the greatest inventor this nation has produced, famously espoused a hands-on experiential approach to education: on the job training. While Edison was the prototype for the journeyman inventor and entrepreneur, the complexity of emerging scientific discoveries quickly outpaced his practical understanding of electromagnetism and the mathematics required to calculate its transmission over distances. His competency based education became his limitations. It left him insolvent for years.

Over a decade ago I created a leading innovation institute and certification program to develop highly practiced innovators. I’ve been lucky enough to work with many of the top companies and organizations celebrated for their innovation prowess. What I have learned firsthand is that contemporary innovators need to understand both theory and practice to be successful. While certifications are a viable means of demonstrating the acquisition of relevant competencies, much in the same way that Girl Scouts earn badges, they do not replace the requirement for deep domain expertise which is developed over time through an integrated curriculum and commensurate pedagogy. Furthermore, competency is merely the price of admission for anyone wishing to truly create anything better or new. That also requires an ongoing understanding of the complex fundamental principles and forces that move our world.

As an outspoken proponent of competency based education for over three decades, what I’ve learned from trial and error on the front lines is that the reason things fail is usually because we confuse why they work with how they work. While new technology and an alternative accreditation system will make higher education better, cheaper and faster, it won’t make it any more valuable. To do that would require changing our perspective on who we value and why we value them. Now that’s a competency worth developing.

Jeff’s Books