Civil LeadershipSocial entrepreneurship

Civil Leadership in Health Care: Seven Transformative Routes to Innovation

Steven de Waal's book 'Make Health Care My Care!'

Dr. Steven P.M. de Waal has a clear message for anyone willing to lead innovation in health care:

Currently the health care system in many countries is stuck in bureaucratic inertia and political indecisiveness—true innovation requires civil leadership from professionals, patients, and communities.

Rather than waiting for top-down reforms, leadership must arise from within society. We need health care professionals, social entrepreneurs, and empowered patients who see the urgency of transformation and show initiative at the front lines.

In his latest book (download synopsis), Make Health Care My Care! Seven Routes to a Healthy Health Care System (published in Dutch), De Waal identifies seven routes that civil leaders are already taking to create meaningful innovation:

  1. Encouraging Civil Leadership
    Empowerment of professionals and citizens who step up as local change makers, moving beyond institutional roles.
  2. Promoting Health
    A shift from illness-focused care to proactive, lifestyle-based health promotion.
  3. Financing Added Health Value
    Funding models that reward real value (patient outcomes), not just volume or compliance with administrative rules.
  4. Organizing Health Care Using the Practical Wisdom of Professionals
    Trusting professionals to shape care delivery based on their frontline experience, minimizing bureaucratic constraints.
  5. Developing Health Care Platforms and Platform Organizations
    Leveraging technology to decentralize and personalize care delivery.
  6. Providing Home Care with Patient Autonomy
    Bringing health care closer to where people live—through neighborhood models, group living, and community organizing.
  7. Encouraging Courageous Leadership
    Boards and leaders must have the moral courage to break old habits and empower bottom-up innovation.

What This Means for Aspiring Leaders in Health Care Innovation:

  • Start local: real innovation often originates in a community or team, not in a government department.
  • Have faith in others’ professional judgment: encourage professionals to organize their own work and co-create with patients.
  • Be a civil leader: use your voice, your position, and your network to initiate change—even without formal authority.
  • Build platforms, not pyramids: think digitally, decentralized, and user-oriented.

Download synopsis Make Health Care My Care! Seven Routes to a Healthy Health Care System

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