Mike Saks
1,2,3,4,5*1 University of Suffolk, Ipswich, UK.
2 University of Lincoln, Lincoln, UK.
3 Royal Veterinary College, University of London, London, UK.
4 University of St Mark and St John, Plymouth, UK.
5 University of Toronto, Toronto, ON, Canada.
Abstract
This paper offers a short commentary on the editorial by Mannion and Exworthy. The paper highlights the
positive insights offered by their analysis into the tensions between the competing institutional logics of
standardization and customization in healthcare, in part manifested in the conflict between managers and
professionals, and endorses the plea of the authors for further research in this field. However, the editorial is
criticized for its lack of a strong societal reference point, the comparative absence of focus on hybridization,
and its failure to highlight structural factors impinging on the opposing logics in a broader neo-institutional
framework. With reference to the Procrustean metaphor, it is argued that greater stress should be placed on the
healthcare user in future health policy. Finally, the case of complementary and alternative medicine is set out
which – while not explicitly mentioned in the editorial – most effectively concretizes the tensions at the heart
of this analysis of healthcare.