BMJ 2002;324:171 ( 19 January )

Letters

Complexity science

    Let them eat complexity: the emperor's new toolkit
    New approaches to evaluation of treatments are needed

Let them eat complexity: the emperor's new toolkit

The first 150 words of the full text of this article appear below.

EDITOR---Plsek and Greenhalgh's example of complexity in health care is absurd.1 Do they really encourage us to believe that, if only Dr Simon had some grounding in complexity theory, she would have been able to understand why getting rid of lunch time upsets her colleagues? We do not have to appeal to the science of complex adaptive systems, chaos theory, catastrophe theory, Einstein's general theory of relativity, quantum mechanics, or even Freudian psychoanalysis to appreciate the distress of Dr Simon's hungry staff.

Although Plsek and Greenhalgh's aim may have been to make some fairly abstract science more accessible, the result is misleading and potentially harmful. The series does not articulate honestly the background to the emerging study of complex adaptive systems by switching repeatedly between misapplied metaphor and empirically grounded science. I suppose contemporary NHS managerialism has to have its own body of knowledge and set of techniques . . . [Full text of this article]
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Relevant Article

Complexity science: The challenge of complexity in health care
Paul E Plsek and Trisha Greenhalgh
BMJ 2001 323: 625-628. [Extract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

Fear of the unknown and the unpredictable
Gary Lafferty
bmj.com, 22 Jan 2002 [Full text]
Re: let them eat complexity
Tom P Marshall
bmj.com, 24 Jan 2002 [Full text]
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