Special Editions

Rogues, Inertia, and the Dogma of Innovation in Health Care

Excerpt from Marc D. Succi’s JACR editorial

At the core of healthcare innovation is developing a skillset to identify problems worth solving and then to solve them. As students enter the research track or medical school, residency, and eventually become Attendings and Principal Investigators, they are constantly embedded into the existing healthcare dogma at every turn – established guidelines, rote memorization, organizational processes, and best practices in the field. While standards are necessary to establish good healthcare outcomes, they are not sufficient, on their own, to move the field forward. Often it can benefit the curious clinician, researcher, or administrator to challenge existing dogma – in fact it is necessary. Radiology, and medicine, evolved because of rogue actors – risk takers who challenged how care was delivered at the time. Take the example of less-invasive medicine. The field, pioneered by luminaries like Itzhak Bentov, Andreas Gruentzig and brought to the bedside by companies like Boston Scientific cofounded by John Abele, challenged eminent surgeons who preferred open approaches to operations… “a bigger hole lets you see more, why wouldn’t you prefer it”? As we now know, less-invasive medicine was a revolution in providing better patient outcomes and reducing morbidity, eventually birthing the field of interventional radiology and procedures adopted by other specialties. But make no mistake - it evolved despite rigid academic institutions and hospitals who stifled collaboration between doctors and industry in the 70s and beyond.

The concepts of learning how to learn, learning how to hypothesize, and ultimately how to innovate are central themes in this special Innovation special issue of the Journal of the American College of Radiology. Novel programs in recent years, pioneered in radiology but now available widely, have created foundational curriculums to teach the principles of problem-based innovation to our trainees and faculty, with documented outcomes…