In my company, looking at the overall big picture, I would say quality and R&D both have the same end goal. We are devoted to developing quality products to make healthcare better. However, the method of reaching that goal is what causes the distinction between R&D and quality. I agree with most people’s opinion that R&D and quality often seem to be fighting one another. While a robust quality system is very critical, sometimes it can swing way too far to the conservative side, and sometimes it can go way too far on the liberal side. It really needs to be somewhere in the middle to ensure that it does not kill innovation. One observation I would make is that in my industry we often see very innovative products being developed by very small, startup companies. The larger companies tend to just have larger portfolios of various products and their “innovations” are usually just tweaks to their existing product lines or acquisitions of the small companies with the innovative products rather than coming up with some new game-changing technology internally. What is the reason for this? The innovative products never would have made it through the quality system of the larger company, whereas the small company with a skeleton quality system were able to develop and launch the product.