This quote captures the core idea of epistemic injustice in healthcare, the tendency to undervalue patient testimony compared to biomedical evidence. The authors are right: multiple studies confirm that clinicians often interpret patient narratives through diagnostic filters, minimizing subjective experiences, especially in chronic or “invisible” illnesses (e.g., fibromyalgia, long COVID).

This example shows how a company used the Balanced Scorecard to test whether its strategy really worked as predicted. By tracking data across perspectives—like employee morale, customer satisfaction, and operational efficiency, it found clear chains of impact: happier employees led to happier customers, which sped up payments and boosted returns. Such evidence strengthens confidence in the strategy. The key insight is that the scorecard isn’t just about measuring results; it’s about proving or questioning the logic behind them. If those links fail to appear over time, leaders know it’s time to challenge their assumptions and possibly rethink the strategy itself, making learning and adaptation part of everyday management.

This part shows how many companies create long, impressive strategic plans that end up collecting dust, while budgets and resources are set in a completely separate process. The Balanced Scorecard closes that gap by linking strategy to budgets and daily operations, so money, time, and effort go to initiatives that truly drive long-term goals. What stands out is the realism of the critique: it’s common for plans to sound great at annual retreats but never shape day-to-day decisions. By forcing strategy and budgeting into one process, the scorecard makes strategy real, ensuring that ambitious objectives don’t just stay on paper but guide actual spending, staffing, and priorities over the year.

What stands out is how this model keeps strategy active and flexible. Instead of treating the plan as fixed, it encourages constant dialogue and learning. For complex environments—like healthcare or fast-moving industries—it’s a reminder that success depends as much on continuous alignment and adaptation as on the original strategy itself.

based on this paragraph, the Balanced Scorecard enables strategic understanding to move beyond the senior leadership team and become a shared organizational practice. By deliberately involving three levels of management, senior executives set financial and customer objectives while middle managers formulate the internal-business-process and learning-and-growth goals needed to achieve them. This broad participation enriches the strategy with operational insights, fosters stronger ownership and commitment at all levels, and ensures that day-to-day activities directly support long-term goals. In doing so, the Balanced Scorecard effectively “bottles” strategic knowledge and distributes it throughout the company, transforming strategy from an abstract plan into a widely understood and actionable framework.