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Zorgbestuur en maatschappij

Hans Hoek reflecteert op ontwikkelingen in gezondheidszorg en maatschappij

Mar 27

Wat kan de dokter leren van de adviseur

geplaatst om 13:58 in categorie Consultancy

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Het kwartaalblad Management&Consulting is een soort vakblad voor organisatieadviseur. M&C Quarterly 1-2017 gaat over de gezondheidszorg. Collega Elsbeth Reitsma en ik hebben daarin een artikel gepubliceerd met de titel ‘Van voorschrift naar dialoog’. C3 is bijna 30 jaar (vanaf 1988) actief in de zorg. Wij gebruiken die kennis om te kijken naar de ontwikkelingen van het adviesvak in de zorg.

Wij signaleren dat de rol van de adviseur in de zorg is veranderd en dat zijn vanzelfsprekende gezag is afgenomen. Onze opdrachtgevers zijn geprofessionaliseerd en geëmancipeerd. Waar men vroeger op ons gezag en onze kennis veranderingen ter hand nam, is er nu een dialoog tussen de opdrachtgever en de professional. Dat heeft ons werk ingrijpend veranderd, maar ook leuker gemaakt. Je moet nu van goeden huize komen met kennis, kunde en ervaring, maar je moet vooral in de dialoog met de opdrachtgever kunnen overtuigen en relatie opbouwen. Het werk is uitsluitend maatwerk. Dat was voor C3 altijd al zo, maar sommige van onze concullega’s rolden hun model uit en daar moest de organisatie zich maar aan aanpassen. Dat kan nu gelukkig niet meer. Wij hebben ons altijd verbonden met de organisatie van onze opdrachtgever en samen met de mensen uit de organisatie ontwikkeld. Toen was dat bijzonder, nu is het een vereiste.

We zien nu dat het spel tussen de zorgprofessional en diens cliënt op vergelijkbare wijze aan het veranderen is. De cliënt/patiënt is mondiger en beter op de hoogte (althans een deel van de patiënten). Patiënten zijn assertiever en zijn zich aan het emanciperen. Het gezag en de kennis van de dokter zijn niet meer vanzelfsprekend. Er zijn andere bronnen dan de informatie in de spreekkamer. De dokter kan niet meer voorschrijven wat de patiënt moet doen, maar moet in dialoog met de patiënt komen tot de beste aanpak.

Adviseurs hebben jarenlang opgekeken naar het professionele systeem van de dokters en geprobeerd dat te kopiëren. Dat is niet gelukt, omdat adviseur geen beschermd beroep is en geen basisopleiding kent. Elsbeth en ik zien het adviesvak dan ook meer als een ambacht dan als een professie.
Het is wel grappig dat zich nu het omgekeerde aandient. De zorgprofessionals kunnen voor hun relatie met de cliënt/patiënt leren van de wijze waarop de verhouding tussen de organisatieadviseur en zijn opdrachtgever zich ontwikkeld heeft. Adviseurs kunnen niet meer voorschrijven hoe het moet, maar gaan de dialoog aan. Zorgprofessionals zijn nu bezig met dezelfde ontwikkeling.


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