Disruption driven by leaders or culture?

David R. Burda, my old boss at Modern Healthcare, offers his thoughts on a healthcare version of an age-old debate: When greatness is achieved, is it because there was a great leader or a set of circumstances that was fertile for greatness? Dave is betting that in healthcare, it will be the visionary leaders like Eric Topol, Atul Gawande and David Feinberg that will shake up the industry.

To me, the answer is almost always both. An organization with a strong innovation culture can be stifled by the wrong leader, after all. That said, if there's hope to turn around an organization -- or an industry -- that has been satisfied with the status quo for too long, it will take visionary leaders to drag it forward, kicking and screaming.