Working Complexity
These pieces are mine to own. The ideas, the positions, the arguments. The writing is a genuine collaboration with Claude — not assistance, not generation, but a working practice I find worth naming. In a field that values honesty about how knowledge is made, that seems the right place to start.
Series · Three parts · Complete
A three-part argument on chronic disease, AI, and the architecture of change in healthcare systems built around the wrong event. Why health systems are structurally blind to the slow transitions that matter most — and what it would take to change that.
Three parts
Series · Two parts · Complete
A two-part exploration of what not-knowing really means in healthcare — and what to do about it. First, a scholarly analysis through four patient personas across the ILD journey. Then, a rigorous advisory board stress-tests every finding and updates its positions in real time.
Two parts
Synthesis essay · Regenerative care
The Polynesian navigator does not know which wave comes next. She knows how to read the ocean. A synthesis of all five bodies of work — soft drift, clinical uncertainty, the certainty complex, what other traditions knew — and the regenerative principles that could guide better care. Not a roadmap. A bearing.
Draws on
Exploration · Three essays · Complete
When do simple rules outperform complex models? A journey through medicine, markets, and organisational design. A complete taxonomy of why heuristics work, when they fail, and how to preserve their wisdom as environments change.
Three essays
The soft drift series argued that health systems are structurally blind to slow transitions. Joan Tronto has been making the same diagnosis for thirty years — as a failure of attentiveness, the first phase of care. On billing codes as moral documents, AI that notices without owning what it notices, and the unpaid attentiveness workforce the event-based economy free-rides on. The essay that joins our complexity argument to her ethics of care.
Read → Position paper · ILD & Complexity Science · June 2026We agree interstitial lung disease is complex — then track it with the simplest instruments we own. FVC as a scalar, the single endpoint, the composite that only aggregates reductions. A position paper on why reductionist measurement is the field's primary epistemology, and the complexity-science toolkit — early-warning signals, symptom networks, joint models, digital twins — that could change it.
Read → Essay · Power & Epistemology · May 2026Rainer Kattel argues that those who most desire power seek it to impose certainty on an uncertain world. Healthcare systems do the same — and suffer the same consequences. Two bodies of thinking, one diagnosis.
Read → Essay · Uncertainty & Economics · May 2026Value of perfect information is one of health economics' most useful concepts. Applied to progressive lung disease — and complex chronic medicine more broadly — it encodes assumptions that do not hold, and creates research priorities that systematically price uncertainty wrong.
Read → Essay · Epistemology & Borrowed Wisdom · May 2026The Polynesian navigator, the Talmudic scholar, and the indigenous fire manager have been working with genuine complexity for millennia. Not as alternatives to rigour — as embodiments of it. What their structural features mean for healthcare design, and whether Western institutions are ready to receive them.
Read → Synthesis · Systems & Practice · May 2026Hard transitions, clinical uncertainty, and the value of information are not three separate ideas. They are the same structural failure, seen from different angles. This essay maps how they connect — and names five practical moves any health system can make now, without waiting for a transformation programme.
Read → Essay · Regenerative Economics · 2026Regenerative economics proposes that health systems should operate more like living ecosystems and less like supply chains. Drawing on experiments in the US, China, Japan and Germany — and asking what legal architecture, evidence and AI need to contribute — we examine whether the UK might be among the first to find out.
Read →Why the most consequential AI in healthcare is being built for insurers, not clinicians — and what that means for who benefits.
Coming soonHealthier SG is the world's most explicit attempt to build relational continuity into a national primary care system. What three years of data shows.
Coming soonThe conventional consulting approach treats system transformation as a complicated problem. It isn't. The category error is structural — and consequential.
Coming soon