Stephen C. Shannon, DO, MPH

Can Osteopathic Medicine Maintain Its Status as Disruptive Innovator?

I recently had the opportunity to attend the 21st Osteopathic Medical Education Leadership Conference, co-sponsored by AOA and AACOM. This year’s conference focused on the concept of “disruptive innovation.” For those readers who have never heard of disruptive innovation, you are not alone; a pre-conference survey uncovered little understanding of the concept among conference attendees.

To help orient us, conference organizers brought in keynote speaker John Kenagy, MD, whose non-medical research and teaching have focused on the strategy of disruptive innovation and the adaptable/distinctive management methods of such resilient, highly adaptive companies as Toyota, Intel and Southwest Airlines.  I have been thinking about this concept as it relates to osteopathic medical education and medicine in general since reading Clayton Christensen’s 2009 book, The Innovator’s Prescription—A Disruptive Solution for Health Care.  Dr. Kenagy, who has worked and studied with Christensen, rekindled these thoughts amidst an audience of osteopathic medical education leaders, and I continue to ponder the implications of disruptive innovation concepts for osteopathic medical education and our health care system.

According to the theory of disruptive innovation, even (and sometimes especially) the highest performing organizations fail to adapt their processes and products over time, allowing new or more adaptive organizations to become strong competitors for market share. Dr. Kenagy makes the point that “historically successful organizational structures, methods and mindsets always slow, stall or stop adaptive innovation.” They simply cannot adapt, he says, when technological, methodological, or (in our case) educational “disruptive innovations” develop.

I would argue that the osteopathic medical profession has a tradition of being a disruptive innovation to traditional medical practice from the time of its founding, and throughout a century of struggle for recognition in the U.S. health care system. Also, and particularly over the past 20 years, osteopathic medical education has served as a disruptive innovator in medical education, and this has been a good role to play. Our primary care, patient-centered, holistic approach to medical education; our rapid growth and establishment of new schools in areas where high need for health care existed; and our community-based, dispersed model of education all gave medical students opportunities that did not exist or were not emphasized in academic medical center-based medical education.

But in contemplating the future success of even the most innovative organizations, Kenagy asks an excellent question: “Will what got us here get us there?” To bring this home to osteopathic medical education, we must ask ourselves both where “there” is, and whether as a now successfully established branch of medical education, we have become entrenched in our own “best practice,” or whether we are continuing to adapt in innovative ways that meet the needs of our “customers”—DO students, residents and, ultimately, the patients they will serve.

We must also attend to the fact that there is increased competition on the innovation front. Both MD and DO medical schools are learning from past experiences and considering what changes are needed to prepare physicians for a new health care environment—one that includes the need to adapt new information and medical technologies, a changing clinical education environment, systems-based practice, and shifting roles and scope-of-practice changes amongst the health professions.

In many ways, we are adapting.  In a pioneering move that responds well to recent calls for more team-based health care, Western University College of Osteopathic Medicine’s innovative interprofessional curriculum is training students in nine health professions to work together for patient wellness. The Lake Erie College of Osteopathic Medicine’s (LECOM) innovative six-year primary care pathway (first year of medical school through residency), the New York College of Osteopathic Medicine’s planned similar family practice-focused six-year curriculum, and A.T. Still University’s School of Osteopathic Medicine of Arizona’s community health center-based clinical curriculum are all important, innovative initiatives.  And in recognition of the different learning styles that exist among students, several colleges have developed new approaches to instruction—problem-based learning programs and independent study programs are just two examples.  

These are just a few of the truly innovative models osteopathic medical education has undertaken to promote excellence and relevance among aspiring physicians. I could cite several others.

Looking ahead, I challenge fellow osteopathic medical educators to recognize the tradition of disruptive innovation that is a part of our profession’s history, and to think beyond historical structures, methods and mindsets to imagine new and better ways to train the physicians that our country needs for its health care future.

To view Dr. Kenagy’s slide presentations, visit here. For more information on the OME Leadership Conference, see the related item in this newsletter.

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February 2011
Vol. 5, No. 2