Diffusion of Innovations


One of the books I have been reading lately is Everett Rogers text Diffusion of Innovations (1). What Rogers has done is demonstrate how an innovation spreads through a social system; his work is what has led to the slightly more recent concept of a “tipping point.” This is the idea that change occurs in a system through what amounts to a domino effect (2)


When we are confronted with an innovation from within a social system (consider, for example, such new technologies as Instagram, Facebook, etc.) we have to consider whether or not to use or participate in that innovation. Rogers notes that there are typically five steps in how we do this. First, we become aware that the innovation exists, and we gather knowledge about it. Second, we form an opinion about the innovation. This step, persuasion, may lead to use considering the innovation positively or negatively. For example, my personal initial opinion regarding myspace was negative. Third, we decide whether or not we wish to adopt the innovation or not. Then, we implement it, and put it into use. Finally, we evaluate our use of the innovation, and confirm that we did the right thing.


But this is at the personal level. There are also influences that come from our social system. Rogers notes one can divide a social system into five groups: innovators, early adopters, early majority, late majority and laggards. Within medical education, for example, Howard Barrows was the innovator who began the initial talks about the use of problem-based learning methodologies. Once his work had been published, a small number of early adopters began to use that methodology. Their colleagues, noticing the success of that method, began to explore use in their own classrooms; these were the early majority. Some people were late to the game, and for whatever reason put off the adoption until its use had been fairly well established. Finally, there were some who, given the choice, refused to consider the use of this method at all. Innovators are those creative types who are in the forefront of technological developments. Early adopters are often seen as opinion leaders and change agents, people whom others see as trustworthy. When we see these people adopt an innovation, that is when we feel comfortable doing the same. This is when the majority begins to use that innovation. Some come to this early, others late. Finally, the laggards are often isolated or traditional in their work environment, and often suspicious of change.


This is but a framework for this theory, which has implications across disciplines, in media, marketing, education and many other areas of life. But as noted, it may also have implications for how innovations in chiropractic can be successfully initiated.


  1. Rogers EM. Diffusion of innovations, 5th edition. New Rok, NY; Simon and Schuster, 2003
  2. 2. Orr G. Review of Diffusion of Innovations, by Everett Rogers. http://www.stanford.edu/class/symbsys205/Diffusion%20%of%20Innovations.htm, accessed August 15, 2008