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31 October 2011
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Lessons from month two as a Clinical Fellow

Reflections on readings and experiences this month are three:

  1. Bureaucracy
  2. Strategy
  3. The lean startup

In Economy and Society, Max Weber claims 'bureaucracy' may be characterised by six central elements:

  1. The principle of jurisdictional areas
  2. The principle of office hierarchy
  3. The presence of written documents 'files'
  4. Specialized office management
  5. Official activity demands the full working capacity of the official
  6. The management of the office follow general rules, which are more or less stable, more or less exhaustive, and which can be learned

The book is dense and I found it hard to read. But I did find skimming the bureaucracy chapter interesting, and it deepened my understanding of the NHS and the advantages and disadvantages of this form of organisation.

Next, I listened to an LSE podcast by Richard Rumelt, an American professor of business at UCLA, speak about his book Good Strategy/Bad Strategy. He describes how to tell good strategy from bad in a way which seems obvious once it's pointed out to you. Bad strategy is characterised by wishful thinking and a poor understanding of the problem, it's vague and in a way it's the absence of any meaningful strategy at all. Good strategy is characterised by correctly identifying and understanding your problem and describing the concrete actions you will pursue to address it. He also suggests ways of detecting bad strategy such as keeping an eye out for 'fluff', which is strategic language devoid of content.

Finally, to pick up on the software developers I met last month and my mission to improve healthcare IT. We set up a mailing list and now have an ever-growing active online community of some 50 incredibly bright and talented doctors and developers, a website, a server, a github repository, some early products, and the early stages of a non-for-profit business – Open Health Care UK!

Which brings me to The lean start up by Eric Ries which is a book that suggests an approach to entrepreneurship. It emphasises rapid development, the use of minimal viable products, and testing rather than asking, to establish what customers want. Which sounds like an effective development technique, and a good way to have a big impact with relatively little resource...

If you're interested in helping to improve Health IT then please do come join the mailing list, we need you! If you'd like to discuss a healthcare related app, solution, or anything else, do get in touch - carl.reynolds [at]



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