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Cormac Russell https://www.nurturedevelopment...-are/cormac-russell/ in “Does more medicine make us sicker? Ivan Illich revisited” helps us to refocus on our efforts to improve individual care and advance system and social change through our organizations and institutions as the drivers of change. For me the practices of implementation science, has greatly brought needed light, tools and analysis to pulling organizations towards practice change. It includes ideas such as co- production as well as keeping an eye on “the external” systems. This article reminded me to shift my institutional interventions mindset to reflect, analyze and cherish community.



(Images: 1) Headline “Does more medicine make us sicker? Ivan Illich revisited” 2) black and white photograph of Ivan Illich)

… While Illich was opposed to institutionalism, he was not against institutions per se. Rather his pamphlets challenged attempts on the part of institutions to monopolize functions related to the production of health and well-being, death, safety, wisdom and justice. Since, he contended, these social goods were not commodities unilaterally produced by institutional systems and thereafter consumed by individuals. Instead, he notes in Tools for Conviviality, there are certain irreplaceable functions that natural communities must perform to be well and to prevail culturally.10 And, if they do not do those things, then there are no institutional tools or systems’ alternatives that can appropriately replace those civic functions.

Indeed, Illich argued that it is not a case of ‘either/or’ (community or institution), so much as a question of, which comes first. He contended that an institutional inversion had taken hold in modern societies, through which the community role becomes that which is left after the institutions and their professional helpers have done what they think they can do better or more expertly. Illich contested this inversion, and argued for its reversal whereby the institutional and professional role should be defined as being that which is left after the community has done what it can and wants to do. …

See the article here: /


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  • Illich-700x300
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