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Culture Case Study: Buurtzorg

  • Writer: Malini
    Malini
  • Jun 4
  • 2 min read

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?



The Dutch Nurses Who Fired Their Bosses (and Made Healthcare Human Again)

Dutch nurse caring

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.


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© 2025 Malini Srikrishna

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