Poking Fun at Service Re-organisations

Tim Jones (University Hospital Birmingham) recently drew the CLAHRC WM Director’s attention to a 2005 paper by Oxman et al. published in the Journal of the Royal Society of Medicine,[1] which he feels you might enjoy. Unlike previous Director’s Choices, this paper does not reveal a counter-intuitive result or refute a long-held theory; instead it shows how revealing humour can be, poking fun at evidence-free management theory and the jargon that covers up this “empirical vacuum”. Some examples:

“We discovered that the literature is almost impenetrable due to creative jargon and the meaningless terminology generated by a variety of cults adhering to different beliefs and led by competing gurus.”

“We identified several over-lapping reasons for reorganizations, including money, revenge, money, elections, money… and no apparent reason at all.”

Of course the Director was reminded of the old refrain:

“We trained hard, but it seemed that every time we were beginning to form up into teams, we would be reorganised. Presumably the plans for our employment were being changed. I was to learn later in life that, perhaps because we are so good at organising, we tend as a nation to meet any new situation by reorganising; and a wonderful method it can be for creating the illusion of progress while producing confusion, inefficiency and demoralization.” – Charlton Ogburn (1957)

— Richard Lilford, CLAHRC WM Director


  1. Oxman AD, Sackett DL, Chalmers I, Prescott TE. A surrealistic mega-analysis of redisorganization theories. J R Soc Med. 2005; 98: 563-8.

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