Reorganising our Heads for the Care of our Health

10 April 2024

Health care is a calling that resides in the personal proficiency of professionals, beyond the technical efficiency of systems. Accordingly, we cannot manage it like a business, through control by top-down reorganizing, technocratic measuring, and the like. This Commentary offers a sequence of five postulates to reorganize our heads instead, beginning with the assertion that health care suffers from success, and ending with a plea for communityship beyond leadership.


Here are five postulates from the article:

Postulate 1:  We may talk incessantly about its failures, but health care, in fact, suffers from success.

Postulate 2: The incessant reorganizing of health care mostly distracts rather than improves the practices of the professionals.

Postulate 3:  Performance measurements are not suited to controlling professional services. It may be easy enough to measure the efficiency of producing automobiles on an assembly line. But how about measuring the proficiency of treating patients in a psychiatric clinic?

Postulate 4: Coming down the administrative hierarchy, the fixes fail at the great divide in health care, where they meet the Professional Assembly which they seek to manage like a Programmed Machine.

Postulate 5:  For the sake of the necessary collaboration, effective organizations in health care will have to foster communityship, beyond leadership.


You can read the full article in BMJ Leader – an international, peer-reviewed, online-only journal focusing on leadership in health and care.