Untangling complexity as a health determinant


As the healthcare system has modernized, it has also become rich with complexity. This complexity continues to foster the creation of wicked problems that at first consideration appear inherently insoluble. To compound matters, policy-makers and decision-makers continue to view the healthcare system in a reductionistic, linear manner. This paper advocates that all stakeholders within the system (policy-makers, providers, and patients) become comfortable with complexity as a determinant of health, and offers tools for productively working with complexity, instead of trying to solve it. These tools include complexity heuristics, adjusting to an emergent decision-making paradigm, and easing the anxiety associated with ambiguity and paradox by becoming antifragile. By adopting these methods, the health determinant of complexity within the Canadian healthcare system can be effectively handled. This will lead to sustainable and scalable interventions, strong patient-partners in care, and efficient use of monetary and human resources.