Book excerpt: How Physicians Can Fix Health Care: One Innovation at a Time Professor Chris Trimble Dartmouth College Penicillin, wonder drug of the 1940s, delivered a dramatic double win. It improved medical outcomes and simultaneously slashed costs. Today's cheap and curative elixirs, however, are not pills. They come instead in the form of innovations in the way care is delivered. Fee-for-service medicine has stood as a formidable barrier to these innovations for decades. Now, thanks to the ongoing transition to value-based payments, there are tens of thousands of opportunities for dramatic double wins. They are found in every hospital, in every clinic and in every medical condition. Policymakers have done their part. The rest is up to innovators on the front lines. Innovators will emerge from every health profession. There will be little progress on the largest opportunities, however, without one essential ingredient: physician leadership. For years, many physicians have felt like mere captives in the game of fixing health care. Physicians are no longer pawns, they are prime movers. A groundswell of physician innovators, determined to rebuild care one step at a time, is exactly what the system needs. The innovations that have the greatest potential are of a certain minimum size. They are characterized by the creation of small multidisciplinary teams - a few people to a few dozen - that are dedicated full time to a single effort to redesign care from scratch for a particular patient population. They deploy providers in nontraditional ways. They sometimes invent entirely new roles and team structures for health care delivery. How Physicians Can Fix Health Care: One Innovation at a Time is the essential step-by-step guide for physician innovators, their teams and the senior leaders in their organizations. Chris Trimble has dedicated his career to studying innovation inside of established organizations. This is his sixth book.