One of the insights in The Innovator’s Prescription, a book about solving the problems afflicting the nation’s health-care system by Clayton Christensen, Dr. Jason Hwang, and Dr. Jerome Grossman, is that we won’t get more affordable health care by asking high-salary individuals to take lower salaries.
Instead, the way to make health care affordable is to push care and treatment out of the hospital to less expensive professionals in lower-cost venues whenever possible.
An example of what this means in health care is to have nurse practitioners in retail health clinics treat patients that have precisely diagnosable diseases with rules-based treatments instead of having pricey doctors in expensive hospitals treat them.
In other words, disruptive innovation in health care will occur by bringing treatment into lower-cost venues enabled by advances in technology, diagnosis, and treatment.
I was reminded of this lesson recently when thinking about the fights over trying to make the nation’s higher education system more affordable. In the same way that we shouldn’t expect expensive specialists to take pay cuts, we shouldn’t expect professors to take pay cuts either.
What that means is that existing traditional institutions of higher education are unlikely to get a whole lot less costly anytime soon. Sure, we might be able to trim around the edges or gain some efficiencies in a variety of places, but in terms of resetting dramatically the cost of higher education in a way that would be fundamentally affordable to all Americans, trying to lower the costs of traditional institutions with existing faculty by an order of magnitude is quite simply a pipe dream.
Disruption is instead occurring in higher education as we bring education out to less expensive professionals with less expertise in lower-cost venues.
This can sound scary though. Who wants to be educated by someone with less expertise?
There is a two-part answer to this question.
First, one of the insights behind disruptive innovation is that it commoditizes expertise. That means that disruption allows people with less expertise to do things that previously required experts. In health care, strep throat formerly required doctors with deep intuition to diagnose it and try to treat it. The advance of medicine now allows people with less expertise to do the same thing but better and more predictably—which incidentally should free up doctors to focus their intuition and expertise on problems for which we don’t yet have rules-based solutions.
In education, the emergence of online learning—and the promise of such things as adaptive learning platforms like Knewton—is beginning to do the same thing for teaching and learning.
Second, the expertise that most traditional faculty members have is not in fact in teaching and learning. It is in doing research. Because of how our higher education system is structured and how professors are trained, they learn very little in the way of how to teach effectively, and the incentives in the system bestow prestige on those who are the best researchers, not teachers.
Although teachers in new disruptive models may lack some of the domain expertise of traditionally trained, PhD-level faculty, when paired with the online learning resources at their disposal, they will have plenty of domain expertise to more than get by. What’s more, the hope is that these teachers will actually have significantly more expertise in the art and science of teaching and learning. Therefore, from the perspective of students in these lower-cost venues, it isn’t just their pocket books that will be better off, but their prospects for learning, too.
Some traditional universities are quick to say that one critical thing will be lost, however: in their institutions, students learn from professors conducting the most cutting-edge research, so as a result students learn the latest and greatest.
This was perhaps true a century ago, but for students who aren’t seeking to be at the cutting edge of research, this point is largely irrelevant. In the majority of classes, students don’t grapple with the frontier of research, and many professors hardly update their lectures from year to year. What many professors teach is also often separated from practice in the field and what students need to learn to do. As many have observed, with the access to knowledge in many fields no longer a scarce commodity, research and teaching are no longer interdependent activities.
Where the traditional universities have it right is that for the foreseeable future, research faculty will continue to teach doctoral students and those grappling at the upper bounds of subjects that are not yet well understood or codified. As my colleague Michelle Rhee-Weise has written, a reason for this is that doctoral programs are designed for students who should be aspiring to be research faculty themselves, and here, research and teaching will remain interdependent activities. But this is not where the volume of students is in higher education.
This has long been one of the insights of the first wave of online universities, but as we see the emergence of massive open online courses (MOOCs) and other such innovations, it is worth reiterating.
Those who fear that the emergence of technology will replace teachers have their worries misplaced. For the majority of students to be successful, they still need teachers to bring material to life, apply it, facilitate conversations around it and so forth. But the nice thing about disruption is that by enabling a whole new group of people who specialize in teaching to offer these programs, we have an opportunity to enable better learning experiences at lower costs. That’s the promise of disruption. Just don’t expect that promise to materialize within traditional institutions with traditional faculty.
