Will disruptive innovations cure health care?

It's no secret that health care delivery is convoluted, expensive, and ofte n deeply dissatisfying to consumers. But what is less obvious is that a way out of this crisis exists. Simpler alternatives to expensive care are already here-everything from Ss eyeglasses that people can use to correct their own vision to angioplasty i nstead of open-heart surgery. Just as the PC replaced the mainframe and the telephone replaced the telegraph operator, disruptive innovations are chan ging the landscape of health care. Nurse practitioners, general practitione rs, and even patients can do things in less-expensive, decentralized settin gs that could once be performed only by expensive specialists in centralize d, inconvenient locations. But established institutions-teaching hospitals, medical schools, insurance companies, and managed care facilities-are fighting these innovations toot h and nail. Instead of embracing change, they're turning the thumbscrews on their old processes - laying off workers, delaying payments, merging, and adding layers of overhead workers. Not only is this at the root of consumer dissatisfaction with the present system, it sows the seeds of its own dest ruction. The history of disruptive innovations tells us that incumbent institutions will be replaced with ones whose business models are appropriate to the new technologies and markets. Instead of working to preserve the existing syst ems, regulators, physicians, and pharmaceutical companies need to ask how t hey can enable more disruptive innovations to emerge. If the natural proces s of disruption is allowed to proceed, the result will be higher quality, l ower cost, more convenient health care for everyone.