dispatches from the new world of work

I Reiterate ...

Reminders: (1) I did some rereading on my 6-hour train trip from Boston to D.C. I re-read The Wisdom of Crowds. I've Blogged it 3 or 4 times already, most recently in my MVP2004 screed. Anybody out there listening ... or reading? Consequences for every project we undertake are enormous. Author Jim Surowiecki at one point quotes Wharton prof J Scott Armstrong, on predictions of outcomes: "I could find no studies that showed an important advantage for expertise. Expertise and accuracy are unrelated." "Experts" included docs, psychotherapists, stockpickers, market researchers and their-our ilk. Do I have your attention?

(2) I also reread Atul Gawande's "The Bell Curve," the amazing 12.06.04 New Yorker article on variations in medical outcomes that I blogged before. Not only does Dr Gawande argue for outcome measurement and results transparency, but he observes that "best practices" are far from an adequate explanation for the frequently hundredfold differences he found in results even among "top" programs. Consider: "We are used to thinking that a doctor's ability depends mainly on science and skill. The lesson from Minneapolis [Fairfield-University Hospital cystic-fibrosis center] are that these may be the easiest parts of care. Even doctors with great knowledge and technical skill can have mediocre results; more nebulous factors like aggressiveness and consistency and ingenuity can matter enormously." I carry around my already dog-eared copy of Gawande's article as a Totem; it keeps me focused on my Healthcare Results passion, and my more general concerns about what makes for excellent professional practice.

(3) I'd like to see some more comments on my 12.17 Post, "Real Estate Joins 'Club Crushing Competition'! Big Time!" I think it's important ... and applies to most all of us. To underscore the importance I refer you to a new Special Presentation, just posted: "The 'PSF' 33: Thirty-Three Professional Service Firm Marks of Surpassing Distinction." I think almost all of us work these days in "professional services." I further think that "good work" is nowhere near an adequate survival ticket. Yearend2004 seminars for three groups—lawyers, investment bankers, realtors—redoubled my commitment to this topic.

Tom Peters posted this on 12/20/04.

Comments

RE: MEDICAL OUTCOMES

From both a knowledge management and an anthropological perspective, I think no one should be permitted to be a physician in a specialty in which they have not been an orderly for at least a couple of years and a nurse for at least three or four more.

Orderlies and nurses each get a different perspective on treatments and outcomes (from each other, too), and without the specific kind of pressure physicians have in making treatment decisions.

Like acting as a native observer, they are "inside" the system, but are forced to see things with a certain remote perspective. Having learned that other angle, they are unlikely to lose it when they themselves become physicians.

Posted by jeff angus at December 20, 2004 7:12 PM