---
id: "concept-amc-innovators-dilemma"
type: "concept"
source_timestamps: ["§ The Rise of Chinese Competition", "¶8"]
tags: ["strategy", "disruption", "change-management"]
related: ["concept-traditional-amc-model", "concept-china-pharma-ascendance", "contrarian-institutional-model-flaw", "quote-innovators-dilemma", "framework-amc-innovation-acceleration", "question-mission-fidelity"]
definition: "The strategic crisis facing U.S. AMCs, where maintaining the legacy practices responsible for past successes causes them to lose global competitiveness to faster, efficiency-driven models."
sources: ["tail2"]
sourceVaultSlug: "hbr-seg-tail2"
originDay: 2
articleStem: "hbr-tail-131-medical-drug-discovery"
sourceUrl: "https://hbr.org/2026/04/u-s-medical-centers-need-a-new-model-for-drug-discovery-and-development"
sourceTitle: "U.S. Medical Centers Need a New Model for Drug Discovery and Development"
---
# The AMC Innovator's Dilemma

U.S. AMCs face a classic **"innovator's dilemma" on a century-scale timeline**. The very practices that made them successful — reliance on **federal grants**, focus on **early-stage science**, and use of **traditional technology-transfer offices** ([[prereq-tech-transfer]]) — are now liabilities in a landscape that rewards **rapid clinical development** (see [[concept-china-pharma-ascendance]]).

The dilemma is *when and how* incumbents should **abandon the legacy business practices responsible for their past successes** ([[concept-traditional-amc-model]]) to adopt leaner, faster, industry-style operational frameworks — **without compromising** their foundational missions of education and patient care. That unresolved tension is captured in [[quote-innovators-dilemma]] and re-surfaces as the open question [[question-mission-fidelity]].

The article's prescription for escaping the dilemma is the five-part [[framework-amc-innovation-acceleration]]. A deeper diagnosis — that **institutions, not just policies**, drive the gap — is argued in [[contrarian-institutional-model-flaw]].