In his 2012 book “Antifragile: Things That Gain From Disorder,” author Nassim Nicholas Taleb describes iatrogenics as “harm done by the healer, as when a doctor’s interventions do more harm than good.” Then, in expanding this idea, Taleb defines general iatrogenics as “the harmful side effects of actions by policymakers and activities of academics.”
We shall use this description of general iatrogenics as the jumping-off point for this article and see what avenues we can explore together.
Imagine the scenario: the manufacturing plant where you work is experiencing issues with its quality, cost and delivery metrics. People around you are scratching their heads, as these challenges seem to have appeared from nowhere, and none of the myriad charts, graphs and reports predicted this strange turn of events.
Across the business, kaizen teams are being hurriedly pulled together to address the perceived glitches in the corporate machinery. Again, no one quite knows what these glitches are, but there must be some special cause variation, mustn’t there? After all, data has never been known to lie.
We must do something! Busy support staff caught up in the fervour, and each kaizen group, driven by their work ethic, plus a bit of healthy competition with the other teams, begin to intervene in the system with the adjustable spanner of their lean techniques. A few days later, the problems have got worse.
Our heroic improvement teams retire to the meeting rooms that are free and ponder a little bit more. Then something miraculous happens. Whilst the Powerpoint presentations are being tweaked, the problems begin to recede. Equilibrium and stability follow shortly behind, and our teams relievedly conclude that their probings were ultimately successful. Congratulations abound, and all return to normal life to await the next crisis.
Of course, the difference for the next crisis is as follows: our now experienced interventionists exclaim, “I have seen this before!” and deploy the trusted methods that were so successful on their last foray. This time, things get somewhat worse than they did before, though again, during some hansei on the sidelines, the problems curiously disappear. More mental data is gathered on the importance of interventionism, and the next cycle is primed.
There is a quote, often attributed to Albert Einstein – of which one of the variants looks a bit like this:
“If I had only one hour to save the world, I would spend fifty-five minutes defining the problem and only five minutes finding the solution.”
In lean circles, we assign this thinking to the habit of going to the gemba with humility, thoroughly understanding the problem and asking “why?”
When we happen upon an improvement opportunity disguised as a problem, there is an overwhelming desire to immediately spring into action – if only to show that we are actively working on the topic.
In the decade I have been working with continuous improvement, I have certainly fallen into this trap. Like a bull at a gate, I have charged in, forgetting to document the current condition and delivering an “improvement” that negatively impacts someone further downstream.
But age and experience have mellowed me. Like many, I now take the time to understand the process that I am looking at. I slowly draw up a hypothesis of the problem root cause and carefully design experiments to test my thinking. I measure at the beginning and end of each PDCA learning cycle, and I ask myself three questions: what do I expect to happen, what did happen, and what did I learn?
And it is the learning that is the key. Sometimes though, I will apply an experiment, and what I expect to happen does not occur. Puzzled, I will stroke my chin thoughtfully and return to my Ishikawa to interrogate another potentiality.
But what if there is no deeply embedded special cause variation or combination of special causes? What if the right thing to do is to do nothing?
One indicator might be if you cannot recreate the problem you are looking at and simply keep coming up against dead ends.
There is no shame in not knowing and taking a step back.
On occasion, that ailment I take to the doctor will disappear faster without treatment than with the aid of the pills and the creams.
The human body is a remarkable machine. It can fix itself, especially if we treat it with care and the autonomous maintenance of good exercise and nutrition.
The same is true of your processes and business systems. The lifeblood of those systems, the experts that run them, will find a way. Sometimes the expert facilitation and tweaking are not required. Trust the machine. More often than not, it will fix itself – not every little thing requires a sticking plaster.
When that desire to do something, anything, surfaces, consider sitting on the sidelines just a little longer. The outcome might surprise you.