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.

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