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My Fascination with Health Care Research

By Reuben McDaniel

Health care delivery problems are tough ones where conflicting issues of access, cost and quality come together for all to see. Many people can’t get health care, when they do get it, it always seems to cost a lot, and even the clinicians who deliver health care are unsure about its quality. These factors are what makes the study of health care delivery so attractive!

I have been thinking about the problems of health care delivery for over 20 years now and continue to be fascinated by them. Some of my work, while conducted in a health care setting, addresses general problems of the management of organizations. A lot of this work has focused on organization decision making and the participation of various stakeholders in the decision making process.

At the same time, most of my research, particularly over the past decade or so has been directed at specific problems in health care delivery, with the goal of developing insights that might improve the condition of patients and/or make it easier for clinicians to do their work. Complexity theories have provided much of the theoretical structure for this research.

A critical insight has been that relationships among service providers within a clinical setting have a major impact on the quality of care that is delivered. It is not enough to have the best doctors or the most well train nurses or the most highly regulated environments. It is not even enough to align incentive systems. 

The way that the doctors, nurses, and other providers relate to each other as they go about caring for patients is critical. And these relationships, when well managed, provide for the sensemaking, learning and improvisation that are required to deliver high-quality care.

I have been lucky to have an exceptional group of researchers working with me. Many of these are former doctoral students including Jim Thomas at Penn State University, Donde Ashmos at The University of Tennessee and Ruth Anderson at Duke University. Many are major scholars at health care research centers around the country including Paul Nutting at the University of Colorado Medical School, Ben Crabtree at the Robert Woods Johnson Medical School in New Jersey and Luci Leykum at The University of Texas Health Science Center at San Antonio. 

These colleagues, and many more like them, have made my scholarly adventures fun as well as productive.

How lucky can you be to be working on interesting problems with top scholars? 

Well, you can have the chance to bring together people from around The University of Texas at Austin campus and from around the country to talk about their research in a symposium “Innovation in Health Care Delivery Systems.”

This is happening April 29-30 at the AT&T Center. To see what an exciting program this is visit


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