Cooperate, coordinate, communicate or collaborate?

Abstract

IN HEALTH CARE we use these ?C? words regularly ? describing what health professionals, patients, consumers, politicians and managers need to do to improve health care systems. A snapshot of each of these is provided below. The Institute of Medicine?s Crossing the Quality Chasm report suggested that cooperation among clinicians was a priority.1 Yet game theorists have long shown that cooperation results in better individual outcomes than competitive behaviour. 2 Driven to achieve the best outcomes, people will choose to cooperate more often than they choose to compete. Most recently, game theory analysis has even been applied to the evolution of cancer, with the resulting conclusion of ?malignancy from cooperation?3 ? tumours grow because it is the nature of cells to cooperate. Given this tremendous innate ?force? for cooperation, why is there the appearance of less cooperation among health system components than we would like?