The Dartmouth Institute for Health Policy and Clinical Practice (TDI) was founded in 1988 by Dr. John E. Wennberg as the Center for the Evaluative Clinical Sciences (CECS).

Among its 30 years of accomplishments, it has established a new discipline and educational focus in the Evaluative Clinical Sciences, introduced and advanced the concept of shared decision-making for patients, demonstrated unwarranted variation in the practice and outcomes of medical treatment, and shown that more health care is not necessarily better care.

Healthy skepticism about new treatments and medical “breakthroughs,” an understanding of the risks and benefits of many common therapies and surgeries, and unique educational programs have produced more informed agents of change among physicians, health professionals, the media, and the public.

Some of the major milestones in TDI's history:


  • First article on Small Area Variation published by John E. Wennberg in Science Magazine


  • John E. Wennberg comes to Dartmouth


  • Northern New England Cardiovascular Disease Study Group formed


  • Center for the Evaluative Clinical Sciences established at Dartmouth


  • First patient choice aids produced in collaboration with Center for Shared Decision-Making


  • Outcomes Group formed


  • MS degree program in the Evaluative Clinical Sciences established


  • PhD degree program in the Evaluative Clinical Sciences established
  • Paul Batalden forms Health Care Improvement Leadership Development section


  • First Dartmouth Atlas of Health Care published
  • Clinical Microsystems program started


  • Spine Center opens at DHMC under James N. Weinstein
  • PhD program graduates its first class


  • First in nation Center for Shared Decision-Making opens at DHMC


  • Health Decision Research section established


  • MPH degree program in the Evaluative Clinical Sciences established


  • Northern New England Cystic Fibrosis Consortium formed under Gerald T. O'Connor
  • MPH program begins


  • Unique Leadership Preventive Medicine Residency program started


  • John E. Wennberg steps down as Director of CECS
  • James N. Weinstein succeeds John Wennberg as Director
  • CECS is reorganized as The Dartmouth Institute for Health Policy and Clinical Practice
  • Six centers are established within TDI
  • Brookings Institute and TDI Collaboration on health reform established


  • The Dartmouth Atlas of Health Care: Tracking the Care of Patients with Chronic Illness marks 20th in series
  • John E. Wennberg receives the Institute of Medicine's highest honor, the Lienhard Award, for "his impact on the evolution of health care delivery in the United States."


  • President Jim Yong Kim and James N. Weinstein create The Dartmouth Center for Health Care Delivery Science


  • Master's in Health Care Delivery Science launched
  • Professional Education and online education classes start
  • High Value Health Collaborative forms
  • James N. Weinstein appointed CEO of Dartmouth-Hitchcock Medical Center; DMS Dean Wiley Souba named TDI's acting director


  • Elliott Fisher named Director of The Dartmouth Institute
  • John E. Wennberg Distinguished Professorship endowed
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