Chers collègues,

Avant un bouquet de printemps cueilli en flânant le long du web, un grand merci à Frédéric Pierru, qui a attiré mon attention le dernier ouvrage du pape du management, et du management médical en particulier, Henry Mintzberg.

Au soir de sa prestigieuse carrière, l’universitaire canadien a publié en 2017 Managing the Myths of Health Care: Bridging the Separations between Care, Cure, Control, and Community. C’est un livre de première importance car il émane du meilleur connaisseur de la question et bat en brèche toute la pensée managériale technocratique dominante, y compris en France. Il affirme la nécessité d’un management médical spécifique non quantophrénique.

Ce livre doit être signalé de toute urgence à ceux qui réfléchissent à l’avenir de nos établissements hospitaliers, à l’Élysée, à Matignon, avenue de Ségur, et bien sûr avenue Victoria, même si Mintzberg explique qu’ils ne sont justement pas les plus aptes pour décider : « Much of the significant change in health care has to come initially from the ground up, not the top down, let alone from experts who have not practiced health care. […] Health care cannot function without management, but it can certainly function without a form of management that has become too common. I call it remote-control management because it is detached from the operations yet determined to control them. It works badly even in business, from where it has come. In health care, it reorganizes relentlessly, measures like mad, promotes a heroic form of leadership, favors competition where there is the need for cooperation, and pretends that this calling should be managed like a business. The more of all this we get, the more dysfunctional health care becomes. […] Most everywhere, the essential problem in health care may lie in forcing detached administrative solutions on to practices that require informed and nuanced judgments. » Continuer la lecture →