Lena Ansmann
1*, Holger Pfaff
11 Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Cologne, Germany
Abstract
In their 2017 article, Mannion and Exworthy provide a thoughtful and theory-based analysis of two parallel
trends in modern healthcare systems and their competing and conflicting logics: standardization and
customization. This commentary further discusses the challenge of treatment decision-making in times of
evidence-based medicine (EBM), shared decision-making and personalized medicine. From the perspective of
systems theory, we propose the concept of individualized standardization as a solution to the problem. According
to this concept, standardization is conceptualized as a guiding framework leaving room for individualization in
the patient physician interaction. The theoretical background is the concept of context management according
to systems theory. Moreover, the comment suggests multidisciplinary teams as a possible solution for the
integration of standardization and individualization, using the example of multidisciplinary tumor conferences
and highlighting its limitations. The comment also supports the authors’ statement of the patient as co-producer
and introduces the idea that the competing logics of standardization and individualization are a matter of
perspective on macro, meso and micro levels.