Part of it is academic: a new Master of Science degree program in Health Care Delivery Science; medical school curriculum reform; an innovative Dartmouth AB/MD degree track; a new PhD program; new executive education programs; a groundbreaking case-writing approach that will support development of research as well as education. Part of it is on the ground: learning from business, from communities, from nurses in the field, from patients in the doctor's office, from wherever ideas are born and consequences are felt. We engage all stake holders, not advocate for any one of them. We approach our work with great humility.