How do you change the world?

My neighbor's son, a 28-year-old First Lieutenant in the Marines, recently returned from his second tour in Afghanistan. This handsome, unassuming young man, whom I've known since he was a toddler, wears the Bronze Star. Chris was honored for numerous acts of bravery during the 40 firefights his platoon engaged in over a single 30-day span. During one, Chris shielded his wounded sergeant with his own body as he called in close air support.

Chris' extraordinary courage reminded me that outcomes are more often determined by the acts of individuals than by the masses. On D-Day the landing on Omaha Beach was very much in doubt – the planned second landing was canceled because the situation onshore was so dire – until a few individuals began moving on their own initiative over the sea wall, through the mine fields, and up the hills. Those individuals became small groups; small groups merged until an entire invading army moved inland.

Indeed, we are often inspired by witnessing the initiative of another, because their simple act reveals a rightness that compels us to follow in step. And, sometimes, with that first step our attitude or sense of self or way of living changes forever.

When I was very young I took a road trip with my parents and two sisters into the Deep South to the historic town of Charleston, S.C. At a gas station stop on the way into town I had my first encounter with raw racism. To this day I remember the wave of fear, revulsion and vague guilt that hit me as I crawled out of the back seat and stared at the "Negro" and "White" labels over the bathroom doors. A "whites only" sign hung on the water fountain in the park across the street. I don't remember that I said or did anything – other than get a drink of water.

On December 1, 1955, in Montgomery, Ala., an African-American woman named Rosa Louise McCauley Parks, a 42-year-old seamstress and secretary of the local chapter of the NAACP, refused the driver's order to surrender her bus seat to a white passenger. Her simple, spontaneous act of civil disobedience sparked the Montgomery Bus Boycott, and eventually another piece of the Jim Crow "separate but equal" perversion ended. Years later Ms. Parks sought to clarify why she broke the law. "People always say that I didn't give up my seat because I was tired, but that isn't true. I was not tired physically, or no more tired than I usually was at the end of a working day. I was not old… No, the only tired I was, was tired of giving in (italics mine)." Not so different from the men who left the shelter of the sea wall and saved America from defeat on Omaha Beach.

Certainly, there is no direct transition to the healthcare supply chain from here. That would dishonor my neighbor Chris as well as those who suffered and died in World War II and America's Civil Rights Movement. But there is a legitimate point of comparison, I think, which is the extraordinary impact of the acts of a few. There are supply chain leaders – a handful spawned a growing consortium – who are rejecting long-accepted industry practices in their determined pursuit of efficiency and savings.

It has been (and probably still is in many organizations) a career-threatening act to propose consolidating control of all non-labor spend under a single leader, or to implement self contracting, or to build a self-distribution infrastructure. But a handful took the risk, and they marked the path up the hill for others. The rightness of these innovations has given impetus to a movement that has progressed well beyond the tipping point. And it is a movement that will transform our industry's best-practice standards.

Campfires and Supply Chain Innovation

When I was a boy, our family did a lot of camping. Tent camping – the real thing. I loved it, not realizing it was the only type of vacation we could afford. My dad was a lowly resident at Duke, and money was carefully titrated. Our weekly dinner menu seldom changed: meatloaf Mondays, creamed chip beef Tuesdays, tuna casserole Wednesdays, and the dreaded fried liver Thursdays. No amount of ketchup could ever squelch my Thursday gag reflex. (To my mother's credit the "special nights" of fried chicken and spaghetti were rapturous.) Camping was different though. Anything cooked over an open fire in the great outdoors tastes good. Even beanie weenies in an iron skillet.

I loved camping. It taught me good lessons about being happy with simple things and about self-reliance. Take the ritual of starting the family campfire. It was a rite of passage ceded solemnly to me by my father when I turned 12. The pressure to perform was immense – success signified manhood, failure unleashed the merciless ridicule of my 2 younger sisters. The ritual began with the painstaking selection of kindling and the studied arranging of rocks for the fire pit. Then, at a moment when the air was still, I would ease a thumb-struck wooden match into the nest of dry leaves, nurture the frail glow breath by breath, twig by twig and stick by stick … until the flames finally danced hot. Only then would I step back and bestow on my family the gift of fire.

The memory of campfires came back to me last week at MediClick's first Strategic Partners Forum, an extraordinary gathering of innovators who are leading by example a mission to transform the healthcare supply chain. I watched as the group, initially tentative and polite, progressed into a candid and spirited exchange, demonstrating keen insight into the problems of the healthcare industry and accepting a shared recognition of their status as role models for change.

It is my experience that profound change often begins as a single spark, but it is fueled to critical mass by the unique power of peer-to-peer interaction. By collaboration.

This is true in many of history's most acclaimed developments. Rosa Parks' refusal to give up her bus seat is my own favorite. In healthcare, Scottish biologist Alexander Fleming's 1928 accidental discovery of the penicillin fungus was actually pretty inauspicious, until others revisited and expanded upon his work some time later. Ultimately, the deciphering of penicillin's chemical composition and refinement of its therapeutic action led to the age of antibiotics and launched an entire pharmaceutical industry. Experimentation, implementation, refinement, replication – all are fostered and accelerated by collaboration.

This is what I saw happening at the Strategic Partner Forum. Some of the members have implemented self-contracting and self-distribution models. Others are currently focused on bringing their market share clout to bear on preference items while relying on national GPO contracts for commodities. All are determined to improve their ability to prioritize opportunities, optimize pricing, measure savings, measure vendor performance, and calculate fees. All are interested in the impact of GS1 and government reforms. All have the courage and the vision and the commitment to lead the way.

MediClick may have supplied the spark, but the Leadership Forum quickly took on a character and durability of its own. I am confident that this forum – this Forum of Innovators – will become the recognized industry focal point for taking back control of the healthcare supply chain. Stay tuned for more.