​Health professionals are well aware of the value of collaboration. The surgery and the emergency room, the care of a single patient always call for different competencies working together in an organised way. Health professionals are also well aware of the value of a single expert - a specialist diagnostician, a skilled surgeon, a researcher inventing new treatments. In an organised health establishment people will at times complain of poor collaboration, at other times of too many people meddling in their work and causing delays. They will complain that they have no help when they need it and too much interference when they want to get on with their work. We will argue that from the perspective of innovation, they are usually always right.

The innovation game is not played on a level playing field. Start-ups - companies under 5 years old owned by one or a small number of entrepreneurs and venture capitalists - will innovate quite differently from established companies, which have a history of successful growth and a market share to defend. Recent start-ups that have grown up, such as Facebook, Google and Netflix are hybrid cases, still youthful and on the warpath for new products and markets, and also with huge existing businesses to consolidate. Here are some of the differences between newly beginning and existing companies.

# Different appetites for disruption
The start-up thrives on it. Challenging the status quo is its bread and butter. ​

Leading innovation in organizations calls for changing strategies (objectives, business models), structures (processes, systems, hierarchies and ways of working) and cultures (behaviors, attitudes and organizational norms). Some attempts at deep transformational change succeed (IBM and Whirlpool are well documented) and many fail (Kodak and Borders books come to mind). The failures are often because of bad timing, skillsets that cannot cope with the unknown and an unreasonable imprisonment within the realm of reason. Here are three tips to overcome these challenges.