National Alliance for Physician Competence Discovery Workshop

Workshop Overview

On August 27-29, 2007, InnovationLabs convened a Discovery Workshop at Catalyst Ranch in Chicago. The purpose of this event was to introduce new concepts and models around complex adaptive systems to the group of people developing what might now become the National Alliance for Good Medical Practice (a vehicle to assure the public of physician competencies). InnovationLabs invited six “catalysts” to present research and experiences from fields as diverse as complexity science, network theory, and non-profit scaling models. The participants used these new concepts to craft visions for the Alliance, its structure, its functions and its development path. These visions will serve as input for the next Summit to be held in Dallas on December 5-7, 2007.

The Workshop began in the evening of August 27 with a dinner and a presentation from Dr. Robert Lindberg. Dr. Lindberg runs a small internal medicine practice in Connecticut. He described his introduction to Complex Adaptive Systems and the subsequent changes he has made to his thinking and his practice of medicine. The language of engineering, Dr. Lindberg argued, implies a determinism that does not exist in nature. The language of complex systems gives us words and images to understand nonlinear behavior, systemic issues, dynamic feedback and other critical factors in a more progressive practice of medicine.

In the morning of August 28, the participants gathered at Catalyst Ranch for breakfast. The group was asked to explore 42 “Concept Cards” – illustrations and descriptions of innovative ideas and models from complexity science – and select the most important and insightful ideas for their work on the Alliance.

Complex Adaptive Systems
After a brief welcome, Bryan Coffman of InnovationLabs gave the group an introduction to a lexicon for understanding complex adaptive systems. Agents in a system typically have a goal of being viable. Agents then develop models of strategies that will help them achieve their goal. As they put those strategies into action, the environment can change in response and the agent learns about the effectiveness of its strategies. The agent can then adapt its strategies through mutation, combination or extremity.

Participants divided into two groups to hear presentations from Norman Johnson and Curt Lindberg. Norman introduced several models for diversity and leadership. Curt gave an overview of complex systems and strategies for managing within them. The participants then split into six different groups to develop strategies around the Alliance’s mission and purpose. The six groups combined into three groups to list the best strategies for the Alliance.

Over lunch, the group divided into new teams to identify the key terms and concepts that they had heard from complex systems.

In the afternoon, the group again heard presentations from Norman Johnson and Curt Lindberg. Norman discussed strategies in complex ecosystems. Curt presented several articles related to an improvement process called Positive Deviance. Participants again divided into six teams to apply the principles they had just learned to the challenge of the Alliance. The focus of this assignment was the different types of Alliance activities described in the original Alliance Proposal.

In the morning of August 29, the participants heard presentations from three new presenters, Marko Rodriguez, Kirsten Moy, and Bill Rouse. Marko discussed distributed decision-making technologies and prediction markets. Kirsten presented her research findings on non-profit organizational models and scale. Bill presented insights around complex systems and strategies for managing change in healthcare as a complex system. Each participant heard two of these presentations, and then divided into four teams to develop proposals for how to structure the National Alliance.

The teams recommended that the Alliance be incubated within another organization for the near future to allow it to continue to experiment, grow and develop. There should be different levels of membership, including owner-members, non-owner members, and just participating members. These members would be organizations, not individual physicians. The Alliance requires a representative steering committee and professional management. The primary functions of the Alliance will be to convene forums for dialogue among stakeholders in the medical community, identify problems or issues that the community is passionate about, organize teams to address those issues, and manage those project teams through to a solution. The Alliance could also support the development and deployment of a strong brand for the medical license.

In the final round of work, four teams tackled a model for the Alliance organization, an action plan for the Good Medical Practice document, a set of objectives for Summit V in December, and another look at the ideas of the “catalysts” for principles and concepts that should continue to be focused on moving forward.

Real Time Record

This web site is a record of the event in Chicago as it happened - captured in real time and presented here in this web site. The documentation of the session includes text and images that were captured throughout the course of each day of the session and is chronological (in the order that things happened). The text is not a transcription of the event. Rather, it represents the documentor's synthesis of the presentations, the team reports and the large group discussions.

This record is intended as a reminder to the participants of the conversations that took place during the retreat, as a stimulus for further conversation and it serves as an artifact of the group's work.

For anyone who was not present at the event reading this, you may lose some of the energy and creativity the participants expressed - and some of the ideas may not translate completely without that context. If you have any questions about the content or anything that is represented here please speak to someone that participated in the process or contact Michael Kaufman at InnovationLabs.


Photographs of participants and their work are included throughout the Real Time Record. To view a larger version of a marker board or chart page, click on the thumbnail image. The larger image will open in a new window.