academic institutions to implement niche educational programs. The second section highlights the lessons for other academic institutions learned from the Pew experience. The third section summarizes (in a nonscientific way) impressions of the collective accomplishments and program impacts. To accomplish these three final tasks, the focus is shifted away from the voice of the participants to a more conceptual plane that makes sense of the Pew legacy as a ''lived experience."
As Hal Luft, Stuart Altman, Marion Ein Lewin, and others have said, we have learned how to do this, and this work needs to continue. Therefore, it is appropriate for this section to consider the future not only in terms of knowledge creation and vision but also the degree of future participation in policy making and policy training. It is unlikely that market forces will mobilize the loosely coupled community of Pew scholars into an active network. There is a need for a few leaders in the group to create a strong organization. The fourth, and final section concludes by offering the Pew fellows thoughts about a path for the future.
This section analyzes the PHPP from a strategic standpoint by employing a analytic framework developed by Heskett.1 According to Heskett (1986) there are four basic elements for success in implementing any service. They are targeting markets, well-defined service concepts, focused operating strategies, and well-designed service delivery systems. Heskett also argues that the four basic elements mentioned above are mediated by three integrative elements: positioning, leveraging, and integrating the operating strategy with the service delivery system. In fact, each of the PHPP sites spent the last dozen or so years honing health policy programs around these basic and integrative elements.
Each of the sites assembled its programs around the four basic elements for strategic success (Heskett, 1986). Sites targeted internal (faculty) and external (fellows) "market" segments and focused on understanding their needs. Each site also carefully crafted a distinct educational service concept in terms of the results that they could produce for fellows and faculty. A third basic element during implementation was developing a focused operations strategy, and the fourth element was designing a system (pedagogy and methodology) for providing educational services.