The Nature of the Business of Healthcare

Hospitals are great icons of modern health care but the nature of the business of health care is that most of it takes place outside hospitals. We need hospitals when our treatments require expensive technology or our illnesses have become difficult to diagnose or unstable. But not for a lot else. We need to shift our thinking to a wider, less medicalised vision of health care with most of it taking place in local communities close to our lifestyles. For example, we are living a lot longer than our parents but many of those extra years come with significant disability for us, particularly with our minds, our bones, our muscles and our senses. Local and social solutions are required as well as medical ones. And for most of us death will not come through infectious disease, under-nutrition or trauma but through uncontrolled blood pressure, continuing to smoke, drinking too much, being sedentary for over 21 hours a day or eating fruitless diets that are too salty, fatty and sugary.

This is becoming a global picture so world health care has to evolve to meet the challenges. Like a maturing woodland it needs new adaptations, relationships and diversity. Health care in local communities is well placed to adopt nature’s business principles (The Nature of Business. Giles Hutchins page 81). Already, it is decentralized, distributed and diverse. So it is well placed to become more resilient. It functions through people working together in loose local structures that easily interconnect to co-create new ideas. So it is well placed to optimise. It is closely connected to patients so can easily respond to new trends in their needs. So it is well placed to be adaptive. It is part of, and has shared goals with, a wider public health system. So it is well placed to be systems based. It comprises health care professionals who are very value driven and powerfully value-led by their professional regulatory organisations. So it is well placed to be values led. Its whole point is to sustain human life and welbeing and it has many beliefs that see human life as an integral part of nature. So it is well placed to support life.

Hovever, health care (along with social care) is increasing seen as a business and risks being molded to conventional business paradigms. These further risk alientating front line care professionals. They report increasing disengagement from what they were trained to do. They increasingly see a business and target driven culture that leave them feeling they are being asked to “hit the target but miss the point.” Excessive adherence to hierarchical business practices, guidelines and policies are leading to health care monocultures. Can we really risk such a deforestation of our health care?

I don’t think so. Maybe a set of world health care systems inspired by nature will give us new paradigms and frameworks that not only ensure health care is sustainable in a business and ecological sense but that it also sustains the health and wellbeing of us humans and our planet.

Authored by Nigel McFetridge. Nigel is a retired GP,professional development coach and a member of the BCI network.