Social Systems Engineering

12Holistic System Design: The Oncology Carinthia Study

Markus Schwaninger and Johann Klocker

12.1 The Challenge: Holistic System Design

Over several decades, health‐care systems all over the world have been grappling with a formidable challenge. The issue is providing an integral kind of care, with the patient at the centre, rather than technology or doctors. Traditionally, over the last four or five decades, hospitals have increasingly suffered from an orientation that hinges on over‐specialization and splintered forms of organization. This orientation threatens the quality of medical care, because patients tend to be treated in a fragmentary way. The perspective on sick people is as if they were conglomerates of organs that can be treated in isolation. The focus is on symptoms. Health‐care systems often lack the ability to deal with syndromes that can have multiple causes with complex interrelationships. Normally, the main concern is applying high technology and advanced medication, instead of warranting patients’ quality of life. While the pharmaceutical industry has been thriving on expansion and soaring profits, critics of modern health systems diagnose a different trend. They have gone so far as to indict these systems of making patients sick instead of curing them, with iatrogenic effects¹ as a rule rather than an exception (Brownlee, 2007; Illich, 1976). Critiques do not only come from ‘outside’ (i.e., from sociology, economics, etc.), even representatives of the medical ...