Sometimes Innovation Is Saying No

Aligning college resources with our strategies and priorities

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Steve Jobs once said, “People think focus means saying yes to the thing you’ve got to focus on. But that’s not what it means at all. It means saying no to the hundred other good ideas that there are. You have to pick carefully. I’m actually as proud of the things we haven’t done as the things I have done. Innovation is saying no to a thousand things.”

Following completion of our most recent strategic plan, in 2014, the ACR embarked on a method to assess its myriad programs against its newly minted strategies and priorities. Our strategic planning consultant, Paul Meyer of Tecker International LLC, facilitated our first strategic program assessment meetings in late 2014 and early 2015. We assessed over 250 individual College programs against the strategic plan by clustering and categorizing them according to the strategic direction each should pursue based on various attributes. The strategic program assessment methodology was originally created by Ian MacMillan, currently professor at the Wharton School, and refined for use by professional societies by Tecker International LLC. This methodology continues to be widely used by organizations to assess their program portfolios. We have continued to use this methodology to periodically reassess legacy programs and evaluate all new programs under consideration.

In the ensuing years, I have been impressed by how translatable the program assessment methodology is to circumstances that may arise in various radiology practice settings. After becoming facile with this technique over the past few years, I thought it may be helpful to share the program assessment principles with our members so that they may better understand how the College leadership prioritizes resources and to consider using a similar technique when various programs must be prioritized within one’s professional practice. I recognize that a healthcare system is potentially more complex than a professional organization. However, this program assessment methodology may be helpful to departments with a rising number of programs, some which may have outlived their usefulness.

Underpinning the strategic program assessment methodology are some key principles. First, we must acknowledge that available resources to meet member needs and expectations are limited. As a consequence, resources should be used judiciously without duplication of services provided by other organizations. Also, as with many effective businesses, focus is critical; providing a large number of middle-of-the-road programs and services is not as effective as excelling in a more limited number of programs and services. Strategic program assessment involves analyzing current and future programs according to the following variables:

  • Program attractiveness: an assessment of how well the program aligns with the strategic plan and meets the vision of the organization
  • Competitive position: an assessment of how well the organization is able to effectively execute and support the program
  • Alternative coverage: an assessment of the degree to which other organizations may provide the same services or offerings to similar constituents

By analyzing each individual program according to these three variables, programs can be triaged into one of eight strategic directions. These directions range from orderly divestment to aggressive competition. For example, items with high program attractiveness, strong competitive position, and a high degree of alternative coverage require the organization to aggressively compete for success in this space. The organization must maintain its strong competitive position in these areas, as such programs can play a very important role in the organization’s future.
Alternatively, programs with high attractiveness to the organization and strong competitive position but low alternative coverage require continued measured growth. Here, the focus area is open to continued dominance by the organization. Programs with high program attractiveness but weak competitive position and low alternative coverage represent opportunities for the organization to build strength and monitor performance. Programs in this category areoften created in response to newly recognized and rapidly growing member needs for which the organization has not yet had the capacity to strongly address. Here, resources and expertise needed to execute the program can be developed while monitoring the operational and financial performance as the program evolves.

Programs with weak competitive position and high alternative coverage may be targeted for divestment regardless of their program attractiveness. For programs that have a strong competitive position and high alternative coverage but are relatively unattractive to the organization, it may be appropriate to build up a competitor that may be better aligned with the program strategically, particularly if the program answers an unmet need. Conversely, programs with a strong competitive position, low alternative coverage, and low attractiveness to the organization may be adopted as “the soul of the organization,” as they support relatively unattractive but critical elements of the organization’s mission. More broadly, such programs also fill necessary but unmet needs of the profession. Finally, programs with low attractiveness, weak competitive position, and low alternative coverage may warrant joint venturing with another organization to improve the program’s attractiveness and competitive position. Joint ventures may be pursued if there is a significant future opportunity to fulfill an unmet need or address a gap in the marketplace.

While this program assessment methodology may seem complex, it becomes second nature after some practice. The three variables of program attractiveness, competitive position, and alternative coverage are applicable to many activities in our professional lives, particularly when the number of such programs and activities exceeds available human, capital, or operational resources. Organizations like ours can’t be all things to all people, and we need to ensure that our resources are used judiciously.


Brink James A. Brink, MD, FACR, Chair

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