Intended for healthcare professionals

Letters Improving healthcare

Time to design a “real health system”

BMJ 2018; 361 doi: (Published 15 June 2018) Cite this as: BMJ 2018;361:k2598
  1. Joachim P Sturmberg, associate professor of general practice
  1. School of Medicine and Public Health, University of Newcastle, Australia, PO Box 3010, Wamberal, NSW 2260, Australia
  1. jp.sturmberg{at}

Changing how we think about healthcare improvement, as Braithwaite suggests,1 does not tackle the key questions facing healthcare systems as “socially designed complex adaptive systems.”2

How many people require healthcare—from whom and where? Most of us are healthy enough to not require health professional services. Kerr White’s groundbreaking study in 1961 showed that health and …

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