This portrayal of the barriers and pitfalls associated with medical innovations offers us a quite candid view of what seems to be occurring in many medical settings. Drs. Frist and Shumway should know given their own record of innovative (and controversial practices).
I would suggest that this portrait complements a more detailed description offered by Everett Rogers and his research companions (Rogers, 1962) based on their own extensive work in bringing about innovative practices (such as water purification) in communities throughout the world. In this essay, I offer my own description, based on Roger’s five stages of diffusion. I will insert quotes from McKenna and Pugno’s book where appropriate, and further enrich my description with the insights offered by Drs. Frist and Shumway.
Diffusion of Innovation
Physician leaders are often seeking to offer new ideas to those they are seeking to influence. The old world and old ideas are no longer of great value. Something new is present or on the horizon. McKenna and Pugno( 2006, pp. 93-108) devote an entire chapter to the notion of physician and pioneer—leading innovation in health care. They quote J. Peter Geerlols, MD (Family Physician, Chief Medical Officer, Allscripts Healthcare Solutions, Inc.), who notes that: “ Not all executives are leaders. Not all physician executives are physician leaders. One of the characteristics of leaders is that they constantly test new and better processes that lead to improved quality and effectiveness.”
In alignment with Dr. Geerlois’s conclusion, a visionary physician leader might declare:
“I am the one to introduce this innovation; furthermore, I keep ahead of other healthcare leaders by offering the new idea before they do. This might mean that I am encouraging the world to embrace an innovation that is absurd or even dangerous. I might instead be offering an innovation that is indeed valid and potentially of great use.”
There would then be a pause, as the visionary leader finds they are also in alignment with Drs. Frist and Shumway:
“The problem is that I can’t get anyone to accept this innovation or even take it for a “test run.” The resistance to my new idea is great. It is indeed hard to learn how to do something differently if we have learned how to do it successfully the ‘good old way’.”
The crisis of medical innovation often resides in the matter of diffusing a new idea. This crisis is exacerbated in a VUCA-Plus world of volatility, uncertainty, complexity, ambiguity, turbulence, and contradiction (Bergquist, 2025a). These conditions in the world of healthcare create a swirling storm of competing ideas that contradict one another and are constantly being revised, removed, or reconsidered.
My colleague, Suzi Pomerantz, identifies this world as a snow globe filled with “flitter” (a combination of flakes and glitter). We can’t see the scene in the middle. We can’t see through the snow globe, because all the flitter is in the way. Ms. Pomerantz suggests that the flitter inside is clouding everything. The globe is constantly shaken and thrown around, so the content inside never settles. Given all of this, an appreciation of innovation diffusion stages is critical for the physician leader.
