The long received wisdom in the organization design, change, and innovation literature is that “form follows function”. We question this dictum particularly for organizations facing radical, volatile changes such as those occurring in the health care sector. Drawing on examples from England, the United States and, to a lesser degree, Australia, Canada, New Zealand, and Singapore we suggest that changes in form often<italic>precede</italic>changes in function. We further suggest that they need to do so in order for the functions to be successfully executed. This is as opposed to past attempts to making functional changes without recognizing the need to first change the organizational form in which the functions are to be carried out. We also discuss the implications of this re-framing for form-function alignment and future research.
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