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This research paper is concerned with the development of relational dynamics in new governing systems in the health sector. Changes brought about in this domain in decision and management structure lead to a reconsideration of relations between the different players in the system, in particular in terms of power and operational approach. This article uses a case study to analyze this new reality and shows how these developments can be sources of value creation and vehicles of a cooperative, productive approach. This article intends to show the interest and scope of the cognitive governing approach applied to the hospital sector. To this aim, the research has three objectives to provoke reflection and discussion: to investigate conflicts between health and administrative staff; to understand how they come about; and finally to determine the actions that enable the management of these conflicts, with a view to establishing a cooperation of creative value and sense between the medical and administrative domains.

A reflection on the evolution of relational dynamics in new systems of governance applied to the health sector