Why Not Big Ideas and Big Interventions?

Published in: Journal of General Internal Medicine, v. 29, no. 12, Dec. 2014, p. 1586-1588

Posted on RAND.org on January 23, 2015

by Robert H. Brook

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There are two basic approaches to developing health policies. The first, which is cautious and careful (a small idea and a small intervention or even a big idea and a small intervention), is more likely to be tested and implemented because institutions and professionals will not be threatened by the magnitude of the change. The second approach is disruptive and daring (big idea and big intervention). It can adequately test a concept, but the concept may be dismissed as infeasible. What would society and physicians propose and accept if they were allowed to be creative and contravening regulations were set aside? This essay explores some possibilities.

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