Making Healthcare Care: Managing via Simple Guiding Principles (Managing the Complex)

In this volume, Hugo Letiche tackles the all-important question, is there “care” in healthcare? If, as Klaus Krippendorff(2006) argues, “meaning is a structured space, a network of expected senses, a set of possibilities. . .[that] emerges in the use of language,” then within the healthcare systems of today, the meaning of “care” has been defined to be the eradication of a problem. We must recognize that patients do not wish to regarded merely as a problem requiring eradication. Letiche is opposed to the very idea that complexity reduction can address the humanity of each individual healthcare situation. He argues that, through narratives and through complexity based social theory, the complexity of each individual situation must be transcended through mindful listening and engaged dialogue. Letiche suggests that in the absence of such mindfulness, the lack of time for true listening, and the inability of providers and systems to allow for patients and family to engage in dialogue lies both the roots of the problem and the potential for its solution. If complexity theory has a role in the analysis understanding and betterment of social systems, then approaches such as the one Letiche undertakes herein will become essential tools of the trade.