Music in the Park. An integrating metaphor for the emerging primary (health) care system

Abstract

Music in the Park is a metaphor for primary health care systems based on shared values of experts and unique local communities. Health professionals are players in this arena, who develop and practise the full range of their skills in response to individual and community needs and preferences. Their leadership works through inspiration and empowerment, making patients 'co-producers' of their own health and 'co-shapers' of their health services.

Towards an Explanation of the Social Value of Health Systems: An Interpretive Synthesis

“…As Sturmberg et al suggest, "metaphors are central to the human understanding of complex issues, " because they allow us to subsume conceptually challenging or unfamiliar ideas with familiar, everyday ideas. 114 As demonstrated above, most of the metaphorical language used in the relational claims took the place of explicitly causal language (such as 'drives, ' 'underlies, ' or 'mirrors, ' rather than 'impacts, ' influences' or 'causes'). It is likely that metaphorical language is so common because it allows authors to imply a complex causal interaction, or a dependence relationship, but not a direct, simple causal connection.…”

“…While the use of metaphor may be an inescapable part of grappling with complexity, the choice of metaphor is important, because metaphors are not only a function of how we speak, but also shape how we think and how we act. 114,128 Using metaphorical language risks obscuring the complex but causal nature of the relationship between health systems and social values, and may therefore, inhibit policy-makers and others from considering health systems as levers for positive social change.…”

Leadership and transitions: maintaining the science in complexity and complex systems

“…The most striking feature of all the papers published in the Forum is the outstanding leadership provided by its authors [1–56] in their particular areas of expertise. However, the Forum would not have been possible without the leadership of two people in particular, firstly Prof Andrew Miles, editor of this journal, who saw the importance for a forum to showcase complexity research in the health domain, and secondly Prof Paul Cilliers, a personal friend and a great intellectual, who influenced the thinking of so many in the complexity field, and whose untimely passing has left a huge gap.…”

Variability, continuity and trust – towards an understanding of uncertainty in health and health care

“…Sturmberg et al . [9] approach the complex nature of the health systems and its interactions through a metaphorical perspective, ‘Music in the Park’. Health care systems are diverse in their settings, their services and their patients; diversity in attitudes, beliefs and preferences for health care require well‐functioning health systems to be sufficiently self‐organizing to manage disparate needs.…”