Purpose – The purpose of this paper is to apply an allied health subculture model to clarify key contextual factors that can emerge in the evolution of an allied health subculture as a consequence of deutero-learning. Design/methodology/approach – Two case studies are compared to illustrate these two extreme variations in deutero-learning. Findings – The first case – characterised by pathological deutero-learning – operated within the classical medical model. A learning pathology that developed in this situation was a fractured, divisive, self absorbed work culture. A second case – characterised by positive deutero-learning – operated within a divisional structure characterized by integrated decentralization. What was learned as a result of operating within this alternative organisational structure is that effective management of allied health recognizes two governance arenas: governance required for managing professionals and governing principles for delivering clinical services. Positive deutero-learning occurred in this situation rather than the reinforcement of existing learning pathologies. Research limitations/implications – There are clearly implications of the two structural models for self-fulfilling prophecies, interpersonal interaction, climate formation and learning pathologies. Practical implications – During a period of major reform differing outcomes in deutero-learning in these two cases emphasize the importance of the evolution of appropriate organisational structures in developing a leadership-driven learning process and creating an environment in which learning can occur. Originality/value – The added value of this application of deuteron learning is that it unpacks the nature of variations in deutoro learning that can emerge during a period of major reform in the evolution of an allied health subculture.