Beyond ABC Medicine: Reframing Reactive Culture
Shift public health culture from reactive ABC (blaming) to strategic ACT (Acknowledge, Co-create, Transform). Design systems that truly heal.
Beyond ABC Medicine: Reframing Reactive Culture in Public Health Systems
In many institutions—especially within public health systems—we often reach for a familiar prescription when tensions rise or outcomes fall short: ABC Medicine.
- A = Accusation
- B = Blaming
- C = Criticising
When teams or leaders feel overwhelmed, misunderstood, or under pressure, reacting with ABC can feel satisfying, like “finally saying what needed to be said.” This kind of catharsis may release tension, but it rarely heals. Instead, it:
When we default to ABC, we treat symptoms—not systems.
What If We Saw the Bigger Picture?
Let’s reimagine ABC not as a medicine, but as a mirror. What if we created the psychological safety to look deeper?
| Old ABC (Reactive) | New ABC (Reflective & Strategic) |
|---|---|
| A: Accusation | A: Acknowledgement: Recognizing process gaps without personal attacks |
| B: Blaming | B: Building: Co-creating solutions instead of assigning fault |
| C: Criticising | C: Collaboration: Engaging diverse voices rather than tearing down efforts |
This shift isn't just semantic; it’s strategic. It moves the focus from who made the mistake to what allowed the mistake to happen.
Concrete Example | Systems vs. Symptoms
For instance, when a critical failure occurs in a lab system, the reactive ABC response leads to a leader firing a technician. Conversely, the reframed ABC response involves leaders Acknowledging the systemic vulnerability, Building a better protocol with the team, and Collaborating with IT to implement new checks. This systemic approach is the only one that prevents recurrence.
From Reactive to Reflective: A Call to ACT
We need a proactive, visible reminder of this new culture. Imagine a dashboard header or folder label that reads:
From ABC to ACT:
Acknowledge · Co-create · Transform
This isn't just a slogan. It’s a call to leadership and a reminder that every Standard Operating Procedure (SOP), every indicator, and every stakeholder summary is an opportunity to move from critique to clarity—from blame to blueprint. The shift requires us to Acknowledge what went wrong, Co-create a new process, and ultimately Transform the entire system to prevent future failures.
Final Thought
Let’s stop prescribing ABC Medicine. Let’s start designing systems that heal—through insight, inclusion, and impact. The shift begins when we consciously choose to Acknowledge, Co-create, and Transform our culture.
The choice is ours: Will we treat symptoms or heal the system?
 |
| From ABC to ACT |
