JRSM > Volume 98, Number 12 > Pp. 563-568

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A surrealistic mega-analysis of redisorganization theories

Andrew D Oxman¹ David L Sackett² Iain Chalmers³   Trine E Prescott⁴

¹ Researcher, Norwegian Centre for Health Services Research, Oslo, Norway
² Director, Trout Research and Education Center, Markdale, Ontario, Canada
³ Editor, James Lind Library, Oxford, UK
⁴ Physician, Medical Genetics, Rikshospitalet University Hospital, Oslo, Norway

Correspondence to: Andy Oxman, Norwegian Centre for Health Services Research Pb 7004, St Olavs Plass, 0130 Oslo, Norway
E-mail: oxman{at}online.no

Background We are sick and tired of being redisorganized.

Objective To systematically review the empirical evidence for organizational theories and repeated reorganizations.

Methods We did not find anything worth reading, other than Dilbert, so we fantasized. Unfortunately, our fantasies may well resemble many people's realities. We are sorry about this, but it is not our fault.

Results We discovered many reasons for repeated reorganizations, the most common being ‘no good reason’. We estimated that trillions of dollars are being spent on strategic and organizational planning activities each year, thus providing lots of good reasons for hundreds of thousands of people, including us, to get into the business. New leaders who are intoxicated with the prospect of change further fuel perpetual cycles of redisorganization. We identified eight indicators of successful redisorganizations, including large consultancy fees paid to friends and relatives.

Conclusions We propose the establishment of ethics committees to review all future redisorganization proposals in order to put a stop to uncontrolled, unplanned experimentation inflicted on providers and users of the health services.

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