The Buurtzorg Method: Practical Applications in France

As the French partner of Buurtzorg and co-founder of both “L’humain d’abord” and “Soignons l’Humain” (those titles roughly translate to “Human first” and “Heal the Human”, respectively) which act as a network of itinerant nurses travelling throughout local areas, Guillaume Alsac has already helped many social organizations provide better healthcare to elderly or handicapped people, in their own homes.

The global vision of his initiative is to provide holistic solutions to personal and systemic problems, by returning the focus of medical professionals towards their patients’ comfort, instead of solely reacting to the financial aspect of their services. With the pandemic greatly accelerating the need for increased flexibility, efficiency and proximity, self-management became the obvious next step in streamlining their services. 

Experimenting with Healthcare Providers' Rate of Pay

This motivated Guillaume to start an experimental project called “Équilibre”, that proposes a new way of calculating healthcare providers’ rate of pay.

They do this by measuring the time spent with their patients, rather than by adding up the costs of each medical procedure they do, while still keeping a dignified, professionally acceptable salary.

By rotating the teams of nurses according to their geographic locations and realigning their professional priorities in a way that centers them on client needs, “Équilibre” can also minimize the number of people that come into contact with the patients.

This also improves the quality of the medical services that are being rendered, while increasing comfort for the patients, who then feel more free to open up and talk to their nurse(s).

Those types of exchanges are invaluable (both mentally and physically) for people who may not have many other options for social interaction... and can even produce better health results, when a patient feels confident enough to reveal previously undisclosed medical information, and have the time and trust to confide in their helpers!

Overcoming Doubters

After turning to the French government in search of funds (and hoping to follow a similar, Dutch initiative) Guillaume’s first proposals were met with doubt.

Strangely, his idea of simply reorganizing nurse salaries in a more egalitarian and fair way, was considered “too basic”... which ironically was by design. The entire purpose of his proposed shift was to create a new system, that is as simple to understand and measure, as possible.

While this may seem like a minor change, the ramifications of such simple adjustments ended up reverberating across each level of the industry and now, patients receive much more care and attention from their nurses than ever before. This is because all the time and energy that these professionals usually spent filling out forms and worrying about bureaucratic requirements to get paid, can now be dedicated to serving their customers.

By recognizing patient autonomy as a priority and avoiding traditional, “top-down” hierarchies that have been prevalent during the last few decades (and focused solely on profit) it’s then possible to initiate change across many different levels in the healthcare sector, without disparaging patients who need “cheap” procedures.

In the past, those with regular “low-cost” needs were routinely considered second-class citizens, as the nurses would always choose to serve clients that paid better. This obviously left many patients in a “no-man’s land” of solitude, lacking care and insufficient allocations, that sometimes wouldn’t even cover their daily needs. Indeed, the price of a service doesn’t imply or create any form of quality, which for a long time was a misconception in the healthcare sector.

Discouraging Unproductive Competition

In opposition to the current way of doing things, Guillaume’s system avoids the negativity and perversity of pitting doctors, nurses and insurers against one another (and against their own interests) due to the complexity of the financial aspect of healthcare, by  concentrating on the source of each workers passion: building empathetic relationships and holistically healing patients.

These elements tend to overlap across each profession, and show once again that by gathering and then consulting experts in an open, egalitarian setting can result in better progress, mutual understanding and an acceleration towards growth and profit, both personally and financially.

Once this framework is installed, it’s then possible to gather a core group of veteran, mature individuals to then deploy in the field and gather feedback.

Data like this, concerning the attribution of new roles, groups of colleagues and regions per group will then be used to ameliorate the performance of younger, less experienced nurses in an effort to scale Guillaume’s project all across France... But this is only possible if the company works on the basis and principle of “shared desire”, meaning that their clients voluntarily offer their consent to try new methods. 

Hope for the Future

So far, the feedback that Guillaume has received has been very promising, with nurses in the field saying that they feel “reconnected” to their original purpose, which becomes easier to embody under these new guidelines.

The patient impact has also been largely positive, because systemic levers have been lifted to lower professional and personal frustration... especially considering that for many patients, this is the first time in their lives that they actually have access to medical professionals, who have time to spend with them.

This changes drastically from previous “carrot and stick” models, because the interactions that happen between the patients and their nurses are no longer framed within a financial context, but a caring, trustful and patient one. 

Discomfort Leads to Evolution

At this point, it becomes apparent that the only difficulty that arises when installing such a method, is the “administrative fragmentation” that is inherent in leaving behind the slow, heavy bureaucracy that institutional systems traditionally impose.

Analysis of data and top-down direction used to be the norm, but it has now become self-evident that a more integrated process and vision are necessary, to be able to survive the business world of the 21st century, while achieving better efficiency and coherence.

This also translates into a paradigm where the industry sectors will present themselves for change and seek out Guillaume’s consulting services, because discomfort leads to evolution.

Sectors that most desperately need change will be the most accepting of his advice, and often prove to be more flexible than some of his other clients, due to their internal recognition of the need for transformation.

The above article was inspired by The NextGen Enterprise's online Thrive-In Session that was hosted by Luc Bretones on March 30th, 2021.