National Alliance for Physician Competence Discovery Workshop


  • The participants were then given an assignment focused on exploring the purpose of the National Alliance considering the axioms: The Purpose of a System is what it does; Form Follows Function.
  • Short Cuts: Use these links to jump to the assignment and to see the post-it notes with what the participants feel are the outputs and processes of the Alliance.

The Purpose of a System is What it Does



Tomorrow morning when you come in there will be a pack of gum on each chair [laughter].

This evening we wanted to introduce you to some new thinking and we also wanted to get your head back into the National Alliance. We want to think about purpose from a different point of view. Stafford Beer said, the purpose of a system is what it does. Public education produces graduates and drop-outs.

That is what it does. After you understand what it does you can talk about what you wish it does.


At your table, describe the major outputs and key processes of the National Alliance. What we would like for you to do is to work in pairs at your table. Take a couple of minutes and read through the assignment when you get it.



The Purpose of a System is what it does

Context: The great cybernetician, Stafford Beer, coined the phrase, “the purpose of a system is what it does.” What we wish it did lies in the realm of visioning and strategy formation. What a system does can be expressed in terms of its recurring and onetime outputs and its key processes. So, the purpose of a school, for example, is to produce both graduates and dropouts, because these are clearly outputs of the system. We may prefer that the school only produce graduates, but until we gain a clear view of what a system really does, we are impotent to change it. Because we’re in the formative stages of the National Alliance, we can envision its purpose—its outputs and key processes.

Objective: Describe the major outputs (recurring and onetime) of the work of the National Alliance for Physician Competence and its key processes. What does this system do in the future?

Process: Please hold a conversation about the objective at your table. It may be more convenient to divide your table into two groups of 4 or 5 people each. You have about 30 minutes for this conversation. Following this time we will have a brief large group conversation about the ideas that have emerged.

Exchange: Write each output of the National Alliance on a yellow Post-it Note and each key process of the National Alliance on a blue Post-it Note. We will collect these this evening. They will be used during the session tomorrow.

Resources: Here is the stated purpose and 18 month plan from the National Alliance draft proposal for your reference. Note that it mostly describes or alludes to processes

Purpose: The mission of the National Alliance for Physician Competence is to assure the public and the health care community that individual physicians are competent to provide safe medical care of the highest quality. Through partnership and collaboration, the Alliance will 1) advocate continuity in the definition, measurement and determination of physician competence across the continuum of education, training and practice; 2) support seamless collaboration among organizations that contributes to physicians pursuit of lifelong learning and improvement; and 3) seek ways to enable reformation of the system of physician self regulation so that it is efficient and effective.

18 Month Plan: The National Alliance’s work plan for the first 18 months will focus on the following activities: 1) developing and advocating endorsement of appropriate metrics for physician competence throughout the continuum of education, training and practice; 2) engaging in early, widespread and continuous communication with a range of stakeholders to convey the importance of and gain support for this work; 3) developing a framework for how data could be utilized by physicians both to support lifelong learning and to fulfill continuing competence requirements; and 4) identifying and participating in pilot projects to develop and promote portfolios and other activities. The following paragraphs detail the Alliance’s potential contributions in each of these areas.

Post-It Notes

Download an MS Word document listing the Key Processes of the Alliance

Download an MS Word document listing the Outputs of the Alliance