The whole enterprise of teaching managers is steeped in the ethic of data-driven analytical support. The problem is, the data is only available about the past. So the way weve taught managers to make decisions and consultants to analyze problems condemns them to taking action when its too late.

I was lucky enough to build on the work of a number of people who had already run laps around this theory-building track. The original classification scheme, years ago, distinguished radical from incremental change. The theory said that established firms managed incremental change well, but would be expected to founder when their industry encountered a radical change.

If you take away religion, you can't hire enough police.

If the theory accurately predicts what they [scientists] see, it confirms that it's a good theory. If they see something that the theory didn't lead them to believe, that's what Thomas Kuhn calls an anomaly. The anomaly requires a revised theory - and you just keep going through the cycle, making a better theory.

Another thing I've observed is how critical the role of the CEO is when a technology truly is disruptive. In looking back on companies that have successfully launched independent disruptive business units, the CEO always had a foot in both camps. Never have they succeeded when they spin something off in order to get it off the CEO's agenda. The CEOs that did this had extraordinary personal self-confidence, and almost always they were the founders of the companies.

There are more than 9,000 billing codes for individual procedures and units of care. But there is not a single billing code for patient adherence or improvement, or for helping patients stay well.

The best strategy is a balance between having a deliberate one, and a flexible, or emergent strategy.