Why thinking outside the box can improve health care

To truly help citizens, professionals sometimes need to dare to deviate from the rules. That was the main message during the meeting on "rebellious professionals" in health care and well-being, held on 15 October in The Hague.

Researchers, students, policymakers, and care providers discussed how courage, trust, and creativity contribute to better services. Within the Population Health program (a collaboration between the Institute of Public Administration and the Health Campus The Hague), growing attention is being paid to these rebellious professionals.

Moderated by Dr. Eduard Schmidt, nurse and researcher Dr. Eline de Kok, doctor in training and researcher Sander Sandkuyl, and Member of Parliament Wieke Paulusma spoke with the audience about this theme.

What is a rebellious professional?

According to De Kok, these are people 'who do things a bit differently, with the right intentions, without harming patients or organizations." They are curious, creative, and trust their professional expertise. Rebellious professionals need persistence and courage to show colleagues and managers why doing things differently can be necessary.

Leadership is key. Direct supervisors can make a big difference by creating space for new ideas. Previous research from Leiden University shows that psychological safety is an important condition for this.

Why rebellious professionals matter

In many public organizations, professionals such as teachers, nurses, and civil servants are often the first to notice when well-intentioned policies fail to help citizens. They deal daily with the complex realities people face.

Research increasingly shows how these professionals navigate such tensions—sometimes bending or breaking rules for the benefit of those they serve, or trying to change their organizations from within. What unites them is their intention: they act differently, not to provoke, but to improve services and make a real difference.

Trust in professional expertise

Drawing on her experience as a community nurse and member of parliament, Wieke Paulusma emphasized the value of rebellious professionals in health care and well-being. They have a positive impact but often remain unseen. Politics can help bring these examples to light, showing that major system reforms aren't always needed for better care.

"We must learn from each other and trust our professionals," said Paulusma. "If we want them to dare to draw outside the lines, we must give them space and trust their expertise."

Encouraging this mindset starts with education, said Sander Sandkuyl. For example, research into entrepreneurial leadership among general practitioners and how this can be incorporated into GP training is an important first step.

Provided by Leiden University