Is mass dysmorphophobia a better term?

EDITOR—After six organisational reconfigurations in the course of 15 years as a consultant I was delighted to read that a respected unit (the Health Services Management Centre) considers that there is no research evidence for the recent change.1 But would it not be useful to study the experiences of those of us, mainly senior nurses and consultants, who have had to carry on delivering clinical services amid the routine changes of management?

For example, it takes at least two years for organisations to work out who does what, to rewrite the priorities and protocol strategies, and to settle arguments within the region/health authority/trusts as to how much money they should have even though they don't have it. Most typical is the reintroduction of arrangements that failed five years ago, under the aegis of a “robust” (or “innovative”) “change facilitation.” There is also no research into what happens to those people displaced by this process. Like sacked football managers they seem to mill around as management consultants or emerge as part of a new agency or a deanery add-on—quango-like organisations generating meetings and paperwork.

Health service management is difficult, and I sympathise with those involved in its current rearrangements. This persistent preoccupation with appearance is a form of …