How America can get its groove back

A medical school alumnus argues that the nation is not doing enough to foster innovation.

John J. Kao, M.D. ’77, M.B.A. ’82, does not even mention his medical degree in the biography for his latest book, Innovation Nation: How America Is Losing Its Innovation Edge, Why It Matters, and What We Can Do To Get It Back.

Medical school at Yale and a psychiatry residency at McLean Hospital were just starting points for a career that has earned Kao the designation of “Mr. Creativity” from The Economist. Along the way he has played keyboards for Frank Zappa; taught at MIT and at Harvard, where he earned his business degree; started two biotech companies; and was production executive on the Palme d’Or-winning film sex, lies, and videotape. Recently he founded a nonprofit, the Institute for Large Scale Innovation.

Despite his distance from hospital corridors, however, Kao said he still draws on what he calls “the implicit curriculum of medicine,” which taught him, “You work hard, and no one works harder than you. You take responsibility and make things happen. And you’re it: when someone comes into the ER at three in the morning, you’re it. I’ve never forgotten those lessons.”

Lately Kao’s hard work has involved advising corporate and government leaders around the world on fostering innovation—and warning Americans that they are not doing enough. Business Week called his book “scary, insightful, and ultimately very useful,” and listed it among the top 10 business books for 2007.

Kao believes that Americans lack a cogent vision of where innovation is taking them, even though half of the world’s research and development money is invested within this country. “No country, not even the United States, can afford to be without a strategy,” he said. Kao defines innovation as the ability of individuals, corporations and nations “to continuously create their desired future.” If the United States wants to chart its own course rather than simply reacting to developments elsewhere, it must foster innovation.

Kao cites Singapore’s innovation strategy as instructive. The island nation of 4.5 million has built a huge research complex called Biopolis, paid for talented young people to earn doctorates in the sciences and recruited researchers and advisors from around the world. In his book, Kao quotes former University of Washington President Lee L. Huntsman, who has called Singapore a “venture capital company masquerading as a government.”

Like Singapore, each nation should foster innovation consistent with its national character and endowments, Kao said. Otherwise, he said, “you don’t make the best use of your opportunities and resources.” The United States, for example, has both strong links between academia and business and a mature venture capital industry willing to take chances on unproven ideas. “And,” said Kao, “we have a very forgiving attitude toward what I would call noble failure. … If you fail in European countries or Asia, typically you’re out of the game.”

America has also benefited by welcoming immigrants: half of those with doctoral degrees in computer science, for instance, come from abroad. “We’d be stupid to imperil that flow of talent into this country,” Kao said. “Many other countries are stepping up to the plate and making their countries highly desirable to immigrant talent.”

Kao advises physicians who value innovation to seek skills and knowledge beyond medicine. For instance, he recommends that doctors earn master’s degrees in business or in public administration. “These days it’s arguably as important to understand how discoveries get into the marketplace as it is to pursue discovery itself. … The more we can do a variety of things in addition to having our core skills, the more we can contribute to society.”

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Expert medical help now available to Connecticut school nurses via new website

School nurse Marcia Wilcox, R.N., didn’t have much luck when she used Google to search for information about learning disabilities caused by a rare bone disorder. A teacher at her school in Connecticut needed to know whether a new student would need extra help as a result of the condition.

Wilcox contacted Janene Batten, M.L.S., at the Harvey Cushing/John Hay Whitney Medical Library, who sent Wilcox four journal articles on the condition, “She was able to find something a lot quicker than I would be able to,” said Wilcox, the sole nurse for about 400 primary school children. “Sometimes I have time, and sometimes I don’t.”

This expert help was available on the “Ask a Librarian” feature on a new website for Connecticut school nurses that Batten established with colleagues Jan Glover, M.L.S., and Lynn Sette, M.L.S. They created the site based on a questionnaire they had sent in the fall of 2007 to the nearly 2,000 nurses and nurse practitioners in Connecticut’s public schools and school-based clinics. Just under half the nurses who filled out the questionnaire said they were too busy during the school day to use the Internet; 44 percent said they lacked knowledge of electronic resources.

The site gives the nurses easy access to 14 databases, including PubMed, the biomedical database for clinicians, and MedlinePlus. Among other resources is a link to the National Library of Medicine’s Drug Information Portal, which provides details about 12,000 medications. The site also provides access to librarians who can help with difficult searches, as Batten helped Wilcox.

The librarians developed the site over two and a half years as part of a $40,000 grant from the National Library of Medicine. They hope that the site, called Connecticut School Nurses Information Resources, can serve as a model for others. In June, the librarians will present a paper about the project at the annual conference of the National Association of School Nurses.

“Unlike a lot of areas of nursing, school nursing is a very solitary practice,” said Joan Cagginello, R.N., M.S., the school nurse administrator of the Milford Health Department. The site is “invaluable,” she said.

The site’s URL is

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An orthopaedic surgeon fights for diversity in medicine

When Claudia L. Thomas, M.D., HS ’80, completed her residency 29 years ago, she was the nation’s first black woman to become an orthopaedic surgeon—though somebody had to inform her of her achievement. Thomas, who gave the Southwick Lecture for the Department of Orthopaedics in November, has devoted her career to making up for that oversight, fighting for diversity in both color and gender in medical schools and in doctors’ offices. Although there has been progress, she said, there’s still a long way to go.

African-Americans make up almost 11 percent of the population but just under 2 percent of orthopaedic surgeons, and only 2.3 percent of orthopaedic surgeons are women. And disparities also extend to treatment: Whites, for example, are 2.4 times likelier to get hip replacements than blacks. Race and gender disparities “are killing people,” Thomas said.

Thomas, an assistant professor of orthopaedics at The Johns Hopkins University School of Medicine, led a diversification effort there that increased the number of African-American orthopaedic residents to 32 percent. “When you have a diverse program,” she said, “it becomes self-perpetuating eventually.”

Bookshelf focuses on books and authors at the School of Medicine.
Send suggestions to Cathy Shufro at

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