Culture Case Study: Buurtzorg
Disclaimer: Culture isn’t copy-paste. What works for Dutch nurses may not work for your startup in Lagos or design agency in São Paulo. But exploring real, working cultures helps us stretch our imagination: what if we really trusted people to do great work — no micromanagement, no middle managers?
Buurtzorg: The Dutch Nurses Who Fired Their Bosses (and Made Healthcare Human Again)
The Problem: Healthcare That Forgot the “Care” Part
Let’s be honest — most healthcare systems are drowning in admin, overwork, and middle management.
In the Netherlands, this was no different. Home-care nurses were spending more time checking boxes than actually caring for patients.
Enter: Jos de Blok, a former nurse who had had it.
In 2006, he started a radical little home-care company with just four nurses, one simple idea, and zero managers.
The idea? “Humanity over bureaucracy.” (Also known as: stop making nurses fill out forms all day.)
The Buurtzorg Model: No Managers, No Silos, Just Care
At Buurtzorg, the entire organization runs on self-managed teams of 10–12 nurses. No supervisors. No call center. No org chart jungle.Each team:
- Hires their own colleagues 👋
- Divides tasks amongst themselves 🧠
- Manages their own schedules and caseloads 📆
- Solves problems locally — no need to “escalate” 💁♀️
And the result? The nurses are happier. The patients are healthier. And the whole thing costs less than the traditional model.
(Yes, you read that right: better care, for less money.)
Culture in Action: How This Actually Works Without Chaos
You might think: “Cool idea. But wouldn’t this just descend into anarchy?”
Fair question. But Buurtzorg makes it work with:
- Massive trust + solid tools: Teams use a simple IT system to coordinate care, share knowledge, and run logistics. It’s not fancy. It just works.
- A tiny, supportive HQ (aka, “the back office”): About 50 people support the whole org — mostly in coaching, legal, and tech. No ivory tower. Just practical help when needed.
- A deep culture of responsibility: Everyone is a professional. Everyone is expected to step up. You don’t need a boss when you’ve got purpose.
As Jos puts it: “People want to be responsible. Just give them the space.”
Results That Speak Louder Than Strategy Decks
- 💸 30–40% cheaper than traditional care models
- ❤️ Top-rated patient satisfaction in the Netherlands
- 👩⚕️ Nurse burnout? Dramatically reduced
- 🌍 Copied in over 30 countries, from Sweden to Japan
This isn’t a quirky experiment — it’s a scalable, proven, wildly human approach to organizing work.
What It Feels Like Inside
- “You’re trusted to make the right call.”
- “We solve things together.”
- “You’re not a number here.”
It’s calm. It’s kind. And it’s radically efficient.
Nurses go from exhausted cogs in a machine to proud professionals running the show. The vibe is less “corporate” and more “we’ve got this.”
Key Takeaways from Buurtzorg’s Culture
- Self-management doesn’t mean chaos. With the right values and tools, it means freedom with accountability.
- Kill bureaucracy, not quality. When you trust professionals to use their judgment, everyone wins.
- Culture isn’t perks — it’s structure. Buurtzorg’s culture works because the org design reinforces it at every level.
- Sometimes less hierarchy = better outcomes. The fewer layers between people and purpose, the more magic you get.
