ABSTRACT
In 1914, with World War I raging, a well-educated captain in the German army was sent to Heidelberg with an important mission. His task: to manage nine existing hospitals and create new ones as more and more troops returned from the increasingly bloody trenches. What the captain found was a medical mess, and he immediately went about trying to organize and improve the hospitals under his control. He did so by introducing them to bureaucracy – a term that ever since has been associated with his name: Max Weber. Today Max Weber is still widely regarded as the world’s most important theorist about the origins and characteristics of bureaucratic organization. The advantage of bureaucracy, Weber wrote, was “its purely technical superiority over any other form of organization.” It brought “precision, speed, unambiguity, knowledge of the files, continuity, discretion, unity, strict subordination, reduction of friction and of material and personal costs.” Since Weber wrote that – now nearly a century ago – bureaucracy became one of the fundamental features of the industrial age. It has been the dominant form of order in government agencies, businesses, schools, universities, and yes, hospitals. Indeed, if Weber came back to visit a big hospital today in an industrial society, he would be amazed at its many medical advances, but not at the levels upon levels of bureaucracy he would find there. Today, however, in advanced, increasingly knowledge-based economies, the industrial age and its institutions are rusting away. And bureaucracy, its primary operational system, is increasingly breaking down. Weber would now discover many private-sector organizations – businesses and NGOs – experimenting with new, post-bureaucratic organizational models and networks. And that bureaucracy has all but become a dirty word. Nonetheless, the public sector in most countries continues to follow Weber, trapped in bureaucratic structures that are increasingly unsuited to dealing with today’s challenges in a variety of critical areas, including public health and security. Nowhere was this more apparent than in the recent creation of the U.S. Department of Homeland Security, which was formed by combining 22 preexisting bureaucracies, plus the sub-and sub-sub-bureaucracies within many of them.
