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Seeking Solutions to Problems!
Mistakes of Mainstream Management [MMM Series]: Chapter 8
Laksh Raghavan
December 29, 2024
This week we continue our Mistakes of Mainstream Management [MMM] series with a call for leaders to stop seeking solutions to their problems.
If you don’t believe that large number of very smart people in a corporate setting can’t be led to solving wrong problems, read on…
We start today’s post with the idea that very large percentage of our population can be made to mask symptoms instead of thinking further about the underlying conditions that led them there in the first place.
I will explain this with an example that we all can related to: Diabetes (specifically, Type 2), a public health crisis that’s unfolding in slow motion in USA. We will then discuss how systems thinking can be applied to dissolving Cybersecurity problems in tech. corporations.
Table of Contents
Quote Bouquet 💐
We are too quick to define what a “problem” is and start seeking a “solution”. But, I think it is better to take your time to formulate what your problem actually is and simmer on that over a few days before you start experimenting with your interventions.
Today’s post is centered around the following quote bouquet from one of my favorite Systems Thinkers, Russell Ackoff:
“The adjective in front of the word ‘problem’ tells us nothing about the problem - it only says something about the person saying it.”
“We fail more often because we solve the wrong problem than because we get the wrong solution to the right problem.”
“In a system, the best way to treat a problem is seldom where the problem appears.”
“A solution to a problem taken separately can create a much more serious problem than the problem solved.”
Diabetes
This disease is very personal to me. My grandmother was diabetic, my mom was diabetic, my dad is diabetic. Tragically, I have lost several uncles, aunts, and other relatives to diabetes and its complications over the years.
CDC's National Diabetes Statistics Report estimates that over 49% of (almost 1 in 2) American adults are either diabetic or pre-diabetic and that number has been growing at an alarming rate over the past several years.
The American Diabetes Association estimates that that the total annual cost of diabetes in 2022 was $412.9 billion. People with diagnosed diabetes now account for one of every four health care dollars spent in the U.S.
One could argue that diabetes is a "gateway disease". When diagnosed with diabetes, most patients are usually put on a prescription of Metformin and for many, the quality of life slowly goes downhill from there. Over the period of the next few years and decades, the dosage and variety of the drugs increase/change and eventually a cocktail of drugs becomes the norm.
For many, diabetes also marks the start of many other health complications: Damage to large blood vessels (heart disease), damage to small blood vessels (stroke), eye disease (blindness), kidney disease, reduced blood flow in the legs and feet, which can lead to infections, non-healing ulcers & potential amputation and many more diseases.
But, what most doctors end up doing in the name of "treatment" is to manage/silence the symptom of ‘high blood glucose’ and not worry about the underlying conditions that led them there - diet, exercise, work, lifestyle and emotional factors at play. So, for many patients ‘high blood glucose’ gets defined as their problem and metformin becomes their solution.
I once asked a doctor: What’s the hardest part of your job?
It wasn’t the stress or responsibility. It was so basic. “Getting my patients to do what I ask of them,” she said.
I didn’t understand at first, but it made sense when she explained.
“You have an appointment with a patient and you say, ‘I need you to get this lab done, see this specialist, pick up this medicine.’ And they come back a month later and they haven’t done any of it.” They either couldn’t afford it, or it was too intimidating, or they didn’t have time.
She explained that becoming a better doctor meant spending more time managing her patients rather than managing those patients’ illnesses. There is a huge difference, she said, between an expert in medicine and an expert in healthcare.
An expert in medicine knows all the right answers out of the textbook. They can diagnose with precision and are up to date on all the latest treatments.
An expert in healthcare understands that medicine from the patient’s view is intimidating, confusing, expensive, and time-consuming. Nothing you diagnose or prescribe matters until you’ve addressed that reality with patients, because even a perfect solution makes no difference to the patient who doesn’t follow it.
Today's nutrition "science" suffers from reductionism. As Marion Nestle, a New York University nutritionist put it:
"The problem with nutrient-by-nutrient nutrition science is that it takes the nutrient out the context of the food, the food out of the context of the diet, and the diet out of the context of the lifestyle."
USA also committed the terrible mistake of chasing efficiency (cost) instead of effectiveness (health) when it came to food. A long time ago, politicians decided that ‘food price’ should never become an election issue and so we solved for making food cheap for everyone which eventually led to the growth of processed "fast" food.
But, we should’ve ideally solved for keeping our citizens healthy with nutritious food. In hindsight, cheap food turned out to be very expensive and we are still paying for it. I hope that we can course correct in the near future - farming, supply chains, incentives, policies, etc.
I will end this section with a call to doctors to reimagine their profession, as elegantly articulated by Abraham M. Nussbaum, MD in his book, The Finest Traditions of My Calling: One Physician’s Search for the Renewal of Medicine:
“What we can do is think of ourselves as something more than technicians in control of the body. At times, we can be like gardeners, teachers, servants, or witnesses to the people we meet as patients.”
For premium tier subscribers, I’ll now discuss how this is related to solving cybersecurity problems in a tech. corporation 👇🏾
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