What passes and fails as health policy and management

David Chinitz, Victor G. Rodwin

Research output: Contribution to journalArticlepeer-review


The field of health policy and management (HPAM) faces a gap between theory, policy, and practice. Despite decades of efforts at reforming health policy and health care systems, prominent analysts state that the health system is "stuck" and that models for change remain "aspirational." We discuss four reasons for the failure of current ideas and models for redesigning health care: (1) the dominance of microeconomic thinking; (2) the lack of comparative studies of health care organizations and the limits of health management theory in recognizing the importance of local contexts; (3) the separation of HPAM from the rank and file of health care, particularly physicians; and (4) the failure to expose medical students to issues of HPAM. We conclude with suggestions for rethinking how the field of HPAMmight generate morepromising policies for health care providers and managers by abandoning the illusion of context-free theories and, instead, seeking to facilitate the processes by which organizations can learn to improve their own performance.

Original languageEnglish (US)
Pages (from-to)1113-1126
Number of pages14
JournalJournal of health politics, policy and law
Issue number5
StatePublished - 2014

ASJC Scopus subject areas

  • Health Policy


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