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Managing the Myths of Health Care: Bridging the Separations between Care, Cure, Control, and Community
“Health care is not failing but succeeding, expensively, and we don’t want to pay for it. So the administrations, public and private alike, intervene to cut costs, and herein lies the failure.”
In this sure-to-be-controversial book, leading management thinker Henry Mintzberg turns his attention to reframing the management and organization of health care.
The problem is not management per se but a form of remote-control management detached from the operations yet determined to control them. It reorganizes relentlessly, measures like mad, promotes a heroic form of leadership, favors competition where the need is for cooperation, and pretends that the calling of health care should be managed like a business.
“Management in health care should be about dedicated
and continuous care more than interventionist and episodic cures.”
This professional form of organizing is the source of health care’s great strength as well as its debilitating weakness. In its administration, as in its operations, it categorizes whatever it can to apply standardized practices whose results can be measured. When the categories fit, this works wonderfully well. The physician diagnoses appendicitis and operates; some administrator ticks the appropriate box and pays. But what happens when the fit fails—when patients fall outside the categories or across several categories or need to be treated as people beneath the categories or when the managers and professionals pass each other like ships in the night?
To cope with all this, Mintzberg says that we need to reorganize our heads instead of our institutions. He discusses how we can think differently about systems and strategies, sectors and scale, measurement and management, leadership and organization, competition and collaboration.
“Market control of health care is crass, state control is crude, professional control is closed. We need all three—in their place.”
The overall message of Mintzberg’s masterful analysis is that care, cure, control, and community have to work together, within health-care institutions and across them, to deliver quantity, quality, and equality simultaneously.
In this sure-to-be-controversial book, leading management thinker Henry Mintzberg turns his attention to reframing the management and organization of health care.
The problem is not management per se but a form of remote-control management detached from the operations yet determined to control them. It reorganizes relentlessly, measures like mad, promotes a heroic form of leadership, favors competition where the need is for cooperation, and pretends that the calling of health care should be managed like a business.
“Management in health care should be about dedicated
and continuous care more than interventionist and episodic cures.”
This professional form of organizing is the source of health care’s great strength as well as its debilitating weakness. In its administration, as in its operations, it categorizes whatever it can to apply standardized practices whose results can be measured. When the categories fit, this works wonderfully well. The physician diagnoses appendicitis and operates; some administrator ticks the appropriate box and pays. But what happens when the fit fails—when patients fall outside the categories or across several categories or need to be treated as people beneath the categories or when the managers and professionals pass each other like ships in the night?
To cope with all this, Mintzberg says that we need to reorganize our heads instead of our institutions. He discusses how we can think differently about systems and strategies, sectors and scale, measurement and management, leadership and organization, competition and collaboration.
“Market control of health care is crass, state control is crude, professional control is closed. We need all three—in their place.”
The overall message of Mintzberg’s masterful analysis is that care, cure, control, and community have to work together, within health-care institutions and across them, to deliver quantity, quality, and equality simultaneously.
272 pages, Paperback
Published May 15, 2017
21 people are currently reading
265 people want to read
About the author
Henry Mintzberg
62 books209 followersProfessor Henry Mintzberg, OC , OQ , Ph.D. , D.h.c. , FRSC (born September 2, 1939) is an internationally renowned academic and author on business and management. He is currently the Cleghorn Professor of Management Studies at the Desautels Faculty of Management of McGill University in Montreal, Quebec, Canada, where he has been teaching since 1968, after earning his Master's degree in Management and Ph.D. from the MIT Sloan School of Management in 1965 and 1968 respectively.
Henry Mintzberg writes prolifically on the topics of management and business strategy, with more than 140 articles and thirteen books to his name. His seminal book, The Rise and Fall of Strategic Planning, criticizes some of the practices of strategic planning today and is considered required reading for anyone who seriously wants to consider taking on a strategy-making role within their organization.
He recently published a book entitled Managers Not MBAs Managers Not MBAswhich outlines what he believes to be wrong with management education today and, rather controversially, singles out prestigious graduate management schools like Harvard Business School and the Wharton Business School at the University of Pennsylvania as examples of how obsession with numbers and an over-zealous attempt at making management into a science actually can damage the discipline of management. He also suggests that a new masters program, targeted at practicing managers (as opposed to younger students with little real world experience), and emphasizing practical issues, may be more suitable.
Ironically, although Professor Mintzberg is quite critical about the strategy consulting business, he has twice won the McKinsey Award for publishing the best article in the Harvard Business Review.
In 1997 he was made an Officer of the Order of Canada. In 1998 he was made an Officer of the National Order of Quebec. He is now a member of the Strategic Management Society.
Henry Mintzberg writes prolifically on the topics of management and business strategy, with more than 140 articles and thirteen books to his name. His seminal book, The Rise and Fall of Strategic Planning, criticizes some of the practices of strategic planning today and is considered required reading for anyone who seriously wants to consider taking on a strategy-making role within their organization.
He recently published a book entitled Managers Not MBAs Managers Not MBAswhich outlines what he believes to be wrong with management education today and, rather controversially, singles out prestigious graduate management schools like Harvard Business School and the Wharton Business School at the University of Pennsylvania as examples of how obsession with numbers and an over-zealous attempt at making management into a science actually can damage the discipline of management. He also suggests that a new masters program, targeted at practicing managers (as opposed to younger students with little real world experience), and emphasizing practical issues, may be more suitable.
Ironically, although Professor Mintzberg is quite critical about the strategy consulting business, he has twice won the McKinsey Award for publishing the best article in the Harvard Business Review.
In 1997 he was made an Officer of the Order of Canada. In 1998 he was made an Officer of the National Order of Quebec. He is now a member of the Strategic Management Society.
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Displaying 1 - 11 of 11 reviews
May 10, 2020
Пізнавально і небанально! Відкриває цікаві аргументи на досить протирічні тези. Відчутні намагання автора думати більш розширеним спектром, а не звичними кліше. Варто почитати усім дотичним до охорони здоров‘я.
November 6, 2018
Попытка обосновать интегральный подход к развитию системы здравоохранения. Не лишено здравого смысла, но слишком много полемики, размытые аргументы, блуждание мыслей.
September 14, 2018
Everyone who works in healthcare, aspires to work in healthcare or is just interested in how healthcare is "managed" should read this book. It's perspective changing and enlightening. I thought it would be dry, but I was happily mistaken! I was excited to read every page.
January 29, 2019
This books highlights a few issues with the health care (focusing on USA, Canada, UK, Italy). The author did a good job getting all these things out that everyone should know.
Reading it will give you a better perspective. It is an easy read and a shorter book so won't take too much time for anyone.
Reading it will give you a better perspective. It is an easy read and a shorter book so won't take too much time for anyone.
May 30, 2018
Valuable lessons for anyone working in the sector.
January 30, 2025
Superb analyses, recommendations less so.
The key part showing that competition does NOT improve healthcare is the part that shows that a gastroenterologist refusing to perform a procedure on a patient until insurance confirmed coverage caused that pt to stay longer in the emergency room and require several blood transfusions, which cost the hospital extra.
Naively thinks, however, that "a spirit of collaboration" can be engendered. He should have read Dr. March Dauphin's *Combat Doctor*, wherein Dr. Dauphin pointed out how the thuggish Quebec Doctor's union, the FMOQ, shut down a new emergency clinic as a result of turf protection, as well as David Levine's *Healthcare and Politics*, wherein Levine points out how the extreme nationalist-infiltrated CLSCs (local health and social service centres) shut down a hospital's proposed and entirely viable home care programme in order to protect its turf.
The key part showing that competition does NOT improve healthcare is the part that shows that a gastroenterologist refusing to perform a procedure on a patient until insurance confirmed coverage caused that pt to stay longer in the emergency room and require several blood transfusions, which cost the hospital extra.
Naively thinks, however, that "a spirit of collaboration" can be engendered. He should have read Dr. March Dauphin's *Combat Doctor*, wherein Dr. Dauphin pointed out how the thuggish Quebec Doctor's union, the FMOQ, shut down a new emergency clinic as a result of turf protection, as well as David Levine's *Healthcare and Politics*, wherein Levine points out how the extreme nationalist-infiltrated CLSCs (local health and social service centres) shut down a hospital's proposed and entirely viable home care programme in order to protect its turf.
July 29, 2017
I received this through a Goodreads contest. This was a interesting read with lots of facts, examples, explanations and a clear even handed approach to out (American) health "industry"; which, is part of our health care crises. He also gave clear well though out alternatives to our current systems that if put in to place would vastly improve our health. Well worth reading no matter which side of the health care "industry" you are on.
August 19, 2018
Regretting I put this aside as long as I did. Mintzberg's style is readable, thought provoking and gently confrontational. Most of references are to his own research and experience, which is makes this less academic and more some practical actions and principles to improve on something that is delivering less and less to all players (users, providers, administrators, policy makers...).
May 30, 2018
Impressive!
Wonderful reading, thrustworthing, wise and collaborative. Huge gift from one of the most respected authors in world management. Thanks Henry Mintzberg!
Wonderful reading, thrustworthing, wise and collaborative. Huge gift from one of the most respected authors in world management. Thanks Henry Mintzberg!
September 26, 2019
Thoughtful, and well written this book is also thought provoking and accurate in its assessments of our healthcare system.
September 24, 2017
This book clearly shows healthcare is truly a myth. The gap needs to be bridged, and a country that looks after the earth militarily has to take care of the taxpayers at home first!
Displaying 1 - 11 of 11 reviews