At first glance, the ES model would seem to make sense. After all, the nation isn't uniform on how care is given nor what priorities are important for one demographic over another. That being said, without a medical strategy coming from the home office, the entire system can't succeed. In the field, we have been told that "you figure out what is important to your customers, and implement within your ES". Uhhhh, no that's not how it works. You (aka home office medical directors) can't just wash your hands on implementing any strategy, and then pass the buck to us in the field. Only for you to take credit should we do your jobs and do it well, or to blame us when things do not work out.
If I keep hearing culture eats strategy for breakfast one more time, I think I'll scream. I'm tired of the corporate lingo, and it only shows how you have no idea what you are doing. How many meetings have we sat in where you hear this lingo and corporate speak, only to end and realize that whoever spoke didn't actually move the conversation forward, nor provide anything tangible for us to seize upon? If the directors can't DIRECT, then they should be replaced by others who can.