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June 9, 2011 International Economic Forum of the Americas Managing the Myths of Health Care Henry Mintzberg © H. Mintzberg.
- 2 - Myths abound in managementmanagers on top, leadership apart, Shareholder Value maximizing shareholder value, strategy formulated on the top to be implemented by everyone else, if you cant measure it, you cant manage it, etc. Myths abound in health care too. Combined, they can be especially destructive. © H. Mintzberg. Some Myths of Management
- 3 - Some Myths of Health Care © H. Mintzberg.
- 4 - Myth # 1: We have a system of health care. Mostly we have a collection of disease cures, or at least interventions, and the more acute the better. © H. Mintzberg.
- 5 - Myth # 2: This system of health care is dreadfully complicated. The technical and professional aspects are surprisingly simple; the complications arise when they are embedded in the social, managerial, and political systems. © H. Mintzberg.
- 6 - Myth # 3: This system is failing. Perhaps it is succeeding, expensively. © H. Mintzberg.
- 7 - Canada has the worst health care system in the world. … except for all the alternatives. © H. Mintzberg.
- 8 - Myth # 4a: The health care system can be fixed by clever, central social engineering. Much of the effective change flows out of the operations, not down into them. © H. Mintzberg.
- 9 - Myth # 4b: Health care institutions can be fixed by bringing in the great leader. Maybe they need more communityship and a different kind of leadership. © H. Mintzberg.
Myth # 4c: The health care system can be fixed by more competition. Maybe there is too much competition, and the need is for more cooperation. © H. Mintzberg.
Myths # 5 & 6: Health care is rightly left to the private sector, for the sake of efficiency. Health care is rightly controlled by the public sector, for the sake of equality. Where is the social sectorfor the sake of quality? © H. Mintzberg.
Myth # 7: No matters which sector delivers the services, business provides the model for managing health care. The field of health care is a calling, not a business. © H. Mintzberg.
Myth # 8: Measurement, evidence-based, must underlie all progress. Measurement is fine so long as it doesn t mesmerize; the trouble is that it so often does, as does scale. © H. Mintzberg.
Reframing Health Care as a System Reframing Organization:beyond hierarchy Reframing Management:as distributed Reframing Strategy:as venturing Reframing managerial style:as care, not cure Reframing the system:as cooperative © H. Mintzberg.
© H. Mintzberg. The Gap Applies at thesystem regional institutional levels Gap Administration Operations
My Big Issues of Health Care The Gap Issue: How to bring the administration closer to the operations, connecting it for support beyond control? The Collaboration Issue: How to get the different parts of health care working in greater cooperative harmony? The Engagement Issue: How to enhance engagement through the promotion of human scale and not just economic scale? The Sector Issue: What is the role of the social sector (not-for- profits, NGOs, etc.) that sit between the now dominant public and private sectors? The Performance Issue: How to balance the needs for efficiency, equality, and quality? © H. Mintzberg.
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