Complexity science

BMJ 2002; 324 doi: 10.1136/bmj.324.7330.171 (Published 19 January 2002)
Cite this as: BMJ 2002;324:171

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Let them eat complexity: the emperor's new toolkit

  1. Ian Reid, professor of psychiatry
  1. University of Dundee, Dundee DD1 9SY
  2. James Paget Hospital, Great Yarmouth NR31 6LA

    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 …

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