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Successful leaders on the journey to better care delivery methods with lower total spending inevitably face pivotal crises. What confluence of attitude, strategy, and events allows them to prevail? Contexts will include entrepreneurship and early stage investing, spread of higher value care delivery innovations, health care delivery system management, and private and public policy making to reward value. Guest faculty will include nationally recognized leaders and change agents, who will invite students to recommend alternative approaches to managing pivotal challenges. The course is open to any member of the Stanford community aspiring to lead higher value in health care delivery including graduate students, undergraduates, and postdoctoral candidates, as well as medical center residents and clinical fellows. May be repeated for credit