The Idea Factory: Where—or, in whom—does it reside?

Dr. Rosenberg
Dr. Rosenberg

The following is based on remarks by Dr. Lawrence Rosenberg in “Contexts of Technological Change in Medicine: Centres and Margins,” a speech that he delivered at an international workshop on innovation at the Jewish General Hospital last spring. This excerpt, as well as others from that address, have been adapted and presented as a series in 360.

These days, we’re often so dazzled by advances in health care, we tend to forget that innovation is an age-old pursuit. After all, why would we look backward, into history, in our drive to innovare—borrowing from the Latin, ‘to make new’? The answer, you’ll find, lies behind every technological leap—in the spirit of the innovator.

Many people hear the words “Kodak moment” and think about a wonderful experience they had years ago, perhaps at Disney World or on their honeymoon. But others think of the Kodak moment in a completely different sense.

Such a moment occurred in 1975, when Steven Sasson, Chief Engineer at Kodak, invented the digital camera. Yes, it was more cumbersome and the resolution wasn’t quite as good as a photo printed on paper. Even so, it was groundbreaking technology and a wonderful innovation. The reaction from management to filmless photography? “That’s cute, but don’t tell anyone about it, and let’s just do our jobs.”

Another Kodak moment occurred about 14 years later, when the board replaced a retiring CEO with Kay Whitmore, who had been with Kodak for over 30 years. Mr. Whitmore represented the best experience that Kodak had: He was very knowledgeable about the film business and entrenched in the Kodak culture.

Mr. Whitmore assured the public there was no need to worry. He would make sure that Kodak stayed close to its core business in film and photographic chemicals. In January 2012, the company filed for Chapter 11 bankruptcy in the United States, having once owned 80 per cent of the film market in the world.

So here you start to see the tremendous cost associated with a reluctance to change and with stubbornly near-sighted vision by leaders of a corporation that for decades was at the centre of an industry.

The next vignette comes from the Cleveland Clinic. Toby Cosgrove, the former CEO, stepped down from the top-ranking U.S. hospital last year after a spectacular run of 13 years. Its clinical program de-emphasized traditional departments, largely in favour of institutes—the largest and most famous of which is its cardiovascular institute, a vast facility with its own building, which is about the size of the entire JGH.

The operating room at the Cleveland Clinic’s cardiac institute bears a huge sign that says, “Through these portals pass the world’s greatest cardiothoracic and vascular surgical teams.” That sign encapsulated the Clinic’s mindset, which is at the top of a healthcare pyramid in the United States—and now around the world, with its centres in Abu Dhabi, Toronto, immanently in London, and elsewhere.

However, with that “centreness”, Toby Cosgrove, was teaching a class of medical students in 2005. The question came up as to how good the care really was at the Cleveland Clinic. Bear in mind that this was a group of medical students, talking to the CEO, who in his own right is a fairly famous cardiac surgeon.

When I spoke to Toby a couple of years ago, he described to me an exchange he had had with a medical student who had said to him, “You know, Dr. Cosgrove, I would have reservations about sending anyone to the Cleveland Clinic.” Taken aback, he asked, “Why is that?” And she replied, “My aunt was here, and she had the absolute worst patient experience that anybody could ever be subjected to.”

And it was from that time forward that Toby Cosgrove made it his personal mission at the Cleveland Clinic to institute its Patience Experience program, which is now world-famous.

The lesson I’ve learned from this is that even those at the epicentre or the pinnacle have to build some flexibility into their plan—because sometimes we don’t know what we don’t know. And we never know where or from whom we’ll discover it.