title: Is organizational complexity the way to improve medical care? Unscientific reflections from going to the doctor in Cleveland and Paris.
abstract: Conventional wisdom suggests that health care will provide better value if physicians are replaced by other caregivers and care is provided less in "silos" and more in "integrated" organizations. By this standard French care appears backwards compared to American care. Yet that does not seem to make US care more efficient or effective. This perspective reviews some differences in practice and suggests why the conventional wisdom should be tested with research.
authors.affiliation: Luxenberg Family Professor of Public Policy, Department of Political Science, Case Western Reserve University, Cleveland, USA Joseph.white@case.edu.
authors.forename: Joseph
authors.initials: J
authors.lastname: White
mesh_terms: D003695:Delivery of Health Care / Q000191:economics / Q000379:methods*; D006282:Health Personnel; D006801:Humans; D038622:Internationality; D009313:National Health Programs; D009820:Ohio; D015279:Organizational Culture; D010297:Paris; D011369:Professional-Patient Relations
keywords: integration; international comparisons; teamwork