Blog: Richard Sennett on Generational Change and Agency in HealthCare 

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Posted on May 20, 2020
Tags:  (Health Care Innovation) 
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COVID-19 has caught us with our system in a state of unpreparedness. 

Is this because we don't evolve rapidly enough as a healthcare industry in Canada or is it possible the problem is that we evolve too often.. more often than it is safe?

That is the argument that Richard Sennet, a prominent American sociologist, makes towards the end of part 2 of CBC's Ideas podcast “Flesh and Stone”. Much of the 2 Hour podcast has nothing to do directly with Healthcare but touches on related issues. Flesh and Stone is mostly a meditation on how the varying approaches of public and private sector institutions affect their workers. It's a good listen from a brilliant mind... (but who has 2 hours these days).

Sennett explains ~ 45 minutes into episode 2 how the cycle of change in medicine used to be based on a Jeffersonian or generational model. In a generational model, change happens once every 30 to 40 years. This change would naturally result in about 4 years of chaos as it would bed in and becomes tacit knowledge. After the 4 years of chaos and reduced efficiency were done society would then begin to realize the benefits of the change.  These benefits would go on for the rest of that generation. The natural evolution of need would cause this process to refresh generally 30 to 40 years later.

He then notes and explains why change now follows a political or business model and is generally on a much shorter ~ four-year cycle. 

This is problematic because the one thing that hasn't changed is the duration of lost productivity due to chaos whenever a change occurs. This can lead to a kind of a perpetual systemic tumult where there is a constant change for the sake of change but the system and it's stakeholders only ever get to live in the chaos phase. They never gets to reap the benefits.

Need driven change probably no longer follows a generational period. ie If we are going by the cyclical emergence of a new need to reform it is likely shorter now.  Sennett's point is more that the cycle is no longer directly tied to need. It is now driven by something more external, such as a political cycle, so it can happen at inopportune moments.

As a sociologist, he is also concerned with understanding and mitigating the effects that unheathy change can have on workers. His areas of academic pursuit also include inquiries into how organizations can foster a sense of individuals' agency and avoid the corrosion of character in the workplace. If you're just in it for the medical parts listen to the end of the 2nd podcast ~ 38 minutes in for the agency explanation and 45 minutes in for the Jeffersonian explanation.


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