Prof. Christensen is Professor of Business Administration at Harvard Business School.

Dr. Bohmer is a physician and a Senior Lecturer at Harvard Business School.

Dr. Kenagy is a physician, a clinical associate professor at the Univ. of Washington and a Visiting Scholar at Harvard Business School.

The following is excerpted from their article, with permission of the publisher.

• Make no mistake: the U.S. health care industry is in crisis...Health care delivery is convoluted, expensive and often deeply dissatisfying to consumers.
• The health care industry desperately needs to open its doors to…disruptive technologies…that may threaten the status quo but will ultimately raise the quality of health care for everyone.
• Disruptive innovations – cheaper, simpler, more convenient products or services…have been one of the fundamental mechanisms through which the quality of our lives has improved...disruptive technologies...can improve, not compromise, the cost, quality and convenience of care.
• Most of the things that afflict us are relatively straightforward disorders whose diseases and treatments tap but a small fraction of what our medical schools have prepared physicians to do.
• We need diagnostic and therapeutic advances that allow nurse practitioners to treat [these] diseases that used to require a physician's care…
• Studies have shown that nurse practitioners…can provide care of comparable quality...
• In addition, studies have shown that nurse practitioners typically devote more time to patients during consultations than physicians do and emphasize prevention and health maintenance to a greater degree.
• Because of advances in diagnostic and therapeutic technologies, these clinicians can now competently, reliably diagnose and treat...disorders that would have required the training…of a physician only a few years ago.
• We need...such disruptions…Unfortunately, the people and institutions whose livelihoods they threaten often resist them…The real reason for blocking such disruption, we suspect, is the predictable desire of physicians to preserve their traditional market hegemony…The resistance is understandable, but it is not in the best interests of the industry or of the patients it serves.
• Instead of working to enable the natural upmarket migration that is an intrinsic part of economic progress, today's managed care organizations, insurers and regulators have…forced highly trained physicians down-market to diagnose ear infections and bronchitis and have prevented nurse practitioners from doing things that technology enables them to do perfectly well.
• Rather than fight the nurse practitioners who are invading their turf, primary care physicians should move upmarket themselves, using advances in diagnostic and therapeutic technologies to perform many of the services they now refer to costly hospitals and specialists.
• Leaders of today's hospitals and managed care companies…the entrenched professions…federal and state regulators, and insurance companies…need to…enable disruptive innovations to emerge…resulting in lower costs, higher quality and greater convenience than could ever be achieved under the old system.

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