Love for patients, for the craft of healthcare, and for the possibility of improvement keeps clinicians and leaders going.
Healthcare, much like the theatre, is a complex production. It requires a sturdy stage, a compelling script, passionate directors, skilled performers, and an engaged audience.
The theatrical analogy is useful for exploring the intricacies of our healthcare system, and the challenges and opportunities it faces. Much like a play, it’s a system that ultimately functions through the dedication of its people. What’s love got to do with it? Everything.
Setting the stage: A multifaceted system
Let’s start by addressing the elephant in the room: the fragmented nature of the healthcare system. But rather than dwelling on its flaws, let’s reframe it as a multifaceted system—one that, while imperfect, offers opportunities for collaboration and innovation.
In our lifetimes, we’re unlikely to see a complete overhaul of the federated system. So, let’s work with what we’ve got. In fact, in its September 2024 report the Commonwealth Fund’s ‘Mirror, Mirror’ report ranked Australia as the best health system out of 10 nations based on access, outcomes and equity.
This pragmatic approach acknowledges the reality of healthcare’s complexity. With thousands of hospitals, community-based organisations, and not-for-profits across the country, the system is a patchwork of lessons, failures, and successes. The challenge, then, is to ensure that the whole becomes greater than the sum of its parts.
People who care and those who receive care
At the heart of the healthcare system are its people, both those who receive care and the people who care for the people. It remains critical to keep patients at the centre of the conversation. If the outcomes for these people aren’t there, if the experience isn’t there, the system needs to be tweaked, redesigned, improved until we get that right.
Equally important are the medical practitioners, nurses, allied health professionals, and countless others who keep the system running. Many if not all of these individuals are driven by a deep love for their work. There’s a certain amount of love that you need to work in health. Commonly, the work is thankless. It’s a tough grind. But it’s that love that keeps the stage lights burning.
This love, however, comes at a cost.
An article by Baigent and Baigent in the Medical Journal of Australia attributed burnout among doctors to their conscientiousness, perfectionism, and inability to say no. These traits, while essential for patient care, create a dangerous cocktail for exhaustion. But they also underscore the resilience and dedication of all healthcare workers, not just doctors.
The theatrical analogy: a framework for understanding our system and how to make it better
To make sense of the healthcare system’s complexity, we can use the metaphor of a theatrical production to illustrate the various components of the system:
- The stage. This represents the infrastructure, policies, standards, cybersecurity and governance that form the foundation of healthcare. The stage must be sturdy, safe, and fit for purpose. There’s no point building a Ferrari if all you need is a go-kart. Accessibility—both in terms of equity and functionality—is also crucial.
- The directors and script. Leaders and policymakers are the directors, responsible for crafting a compelling narrative and bringing it to life. But good policy, like a good script, is meaningless if it doesn’t resonate with its audience. Passion, commitment, and clarity are essential to ensure that reforms are not just theoretical but actionable. Using a framework like the UK Design Council’s ‘double diamond’ approach ensures stakeholders are involved at critical points in co-design.
- The performers. Clinicians are the actors, each with their own strengths and needs. Drawing on the Hersey-Blanchard model, we can categorise performers into four types:
- Novices who require significant support and direction.
- Emerging talents who need coaching to reach their potential.
- Workhorses who may not shine but are reliable and essential.
- Leaders who excel with minimal intervention, like Meryl Streep delivering an Oscar-worthy performance, or even appearing in Mamma Mia.
- The backstage crew. Often overlooked, these are the coders, IT specialists, HR teams, clinical governance experts and others who work behind the scenes. Without them, the show simply couldn’t go on.
- The audience. The patients, whose needs and experiences should guide every decision. If there’s no audience, there’s no show. If the audience leaves unhappy and unfulfilled, then you may question the point of the performance. Everyone involved in the show wants to see smiles in the audience.
Love as the glue
When I write about love, I don’t mean it in a sentimental sense. I mean it rather as the driving force that ultimately sustains the system, despite its imperfections. Love for patients, for the craft of healthcare, and for the possibility of improvement keeps clinicians and leaders going, even in the face of burnout and systemic challenges.
This love also fuels innovation. While continuous improvement is vital, we should be wary of becoming too focused on incremental change. To quote Yuval Noah Harari, “The electric light did not come from the continuous improvement of candles”. Sometimes, radical thinking is necessary to achieve breakthroughs.
Just like thespians putting on a play, we must constantly rehearse, innovate, and improve. Perfection is an unattainable goal in a dynamic field like healthcare. Instead, the focus should be on good practice, learning from failures, and iterating as we go.
We should also be kind to our more critical friends: journalists, academics, evaluators, and others who challenge the system and hold it accountable. These voices, while sometimes uncomfortable, are essential for driving progress. Some directors claimed to have never read their reviews. They were almost all lying.
A standing ovation
This theatrical analogy is intended to serve as a powerful reminder of the interconnectedness of the healthcare system. From the stage to the audience, every element plays a role in creating a production that is greater than the sum of its parts.
But perhaps the most poignant aspect of what we do remains the recognition that we love doing it. As the journalist Martha Gellhorn once said of her own work, “it is the only thing I know absolutely and irrevocably to be good in itself”. It’s precisely this sense that drives clinicians to care for their patients, leaders to push for reform, and backstage crews to keep the wheels turning. It’s a love that, despite the system’s imperfections, ensures that the show goes on.
Dr Paul Eleftheriou is principal and co-lead of digital health at Nous Group. This piece is an edited version of a speech delivered by him at the Wild Health Towards One Healthcare System Summit in Canberra on 18 June 2025.