Introducing the Forces of Change Eric D. Kupfeberg, PhD Senior Assistant Dean, CPS, NEU 8 September 2010

Doctorate in the history and sociology of science from MIT Masters in the history and philosophy of biology from the University of Maryland Senior Assistant Dean of Academic and Faculty Affairs Responsible for overseeing 9 graduate degree programs and more than 15,000 students He is also responsible for the growth of Northeastern University’s program in Regulatory Affairs of Drugs, Biologics, and Medical Devices Eric D. Kupferberg, PhD

“ Show me the book of the next Beautiful Theory... and I promise you these blind eyes will see again.”

The Analytical Language of John Wilkins belonging to the Emperor embalmed trained piglets sirens fabulous stray dogs included in this classification trembling like crazy innumerables drawn with a very fine camelhair brush et cetera just broke the vase from a distance look like flies

Between Maps & Models We present an analytic guide to market forces in health care, not a perfectly comprehensive map In his 1946 story “The Exactitude of Science,” Jorge Borges imagines a cartographical effort so thorough that the physical map covered the entire empire Following generations realized that the “vast Map was Useless” and discarded it to the “Sun and Winters” Jorge Louis Borges ( )

Between Maps & Models We offer an instructional model that is “good to think with” Comparable to Claude Levi- Strauss’ notion of Bricoleur Goal is to provide an “analytic tool box” that is both versatile enough to cover the breadth of changes in the health care market place and flexible enough to identify strategic opportunities and direct strategic planning

Enlisting Stakeholder Theory For the moment, we borrow heavily the work of French sociologist Pierre Bouridieu When we discuss alternatives to the current pattern of model of unbridled stakeholder competition, we will enlist the work of R.E. Freeman, a Professor of Business Management at the University of Virginia

Between “Fields” and “Stakeholders” A “field” is structured system of social or market positions – occupied either by individuals or institutions – which defines the situation for their occupants The field forms an arena within which parties maneuver or compete over capital or desirable resources (e.g., market share or social capital) “Stakeholders” are groups of individuals or institutions that share a set of core interests and have ability take actions in pursuit of those interests.

Elements of an Unsystematic System The health care market comprises a disorganized aggregate of diverse parties or groups Each group pursues its own interests with marginal regard for the interests of other parties or groups Each views the health care market as a zero-sum game All parties view the current health care market as sub- optimal

Identifying the Stakeholders A stakeholder is a group of individuals or institutions that share a set of core interests and have ability take actions in pursuit of those interests. Stakeholders can vary in their homogeneity Each stakeholder category greatly influences the health care market

Understanding Bourdieu’s Fields

Utility of Actor-Network Theory?