Scott’s parabola gives hope

Scott described the growth and death of fads in surgery:

It’s not so different from the curve based on real data published by Walsh which observed the fate of other management fads:

Walshe, K. Pseudoinnovation: the development and spread of healthcare quality improvement methodologies. International Journal for Quality in Health Care 2009; Volume 21, Number 3: pp. 153–159.  DOI:

Walsh does not specify whether the slow growth of the accreditation line includes ISO accreditation.  It probably refers to non-ISO schemes since it doesn’t reflect the faltering curve for ISO 9001:

The significant life cycle of other methodologies is usually less than a decade.  Peaking for only a few years has been enough to ensure their decline because of undramatic effects.

The ISO inspection cartel has captured the minds of professional leaders.  Its compulsion to purchase a rehashed document every few years has kept it going longer than other pseudoinnovations.  Managers always love a new fad to waste money on and keep staff stressed.  It saves them from the dreariness of continual improvement or the risks of radical improvement.

Unlike surgery where the effects of innovations become clear and are audited, nobody bothers trying to measure outcomes meaningfully in many other fields.

UK governments boast of how much taxpayers’ money they have spent on the NHS.  They don’t say how much is wasted and few ask.  Money spent does not necessarily relate to benefits.  In an industry with price discovery through profit and loss accounts, managers would wise up or close down.

That’s why we need more academic investigation of why the ISO continues to not die.


This entry was posted in History, Management, Medicine, NHS and tagged , , , , , . Bookmark the permalink.

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