Like ecosystems in nature, healthcare systems are complex, interdependent systems. Does that mean they should be left to the forces of slower, evolutionary transformation? Given the pressures and expectations on public healthcare, the more deliberate hand of a gardener may be needed to "weed out" programs that are no longer fruitful in solving current issues. Taking such a discerning view of health system programs would mean re-examining attitudes about failure. Just as harvested plants provide compost that feeds the garden, knowledge gained from failure can strengthen healthcare. A public environment that favours "success stories" means other system participants don't get the benefit of the knowledge that can be gleaned from failure. Scientific disciplines advance knowledge by studying failed experiments. Health leaders must do the same. Even programs deemed "success stories" have likely failed in some ways, experience that should be shared as transparently and widely as the successes. Both notable successes and valiant failures can be equally valuable in designing health system programs that meet the needs of all patients.

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