Cowboys vs. Pit Crews (Thoughts from TED 2012)

Atul Gawande told a fascinating story yesterday at TED about some of the challenges facing healthcare in America. However, as he talked, the implications for business and non-profit leaders became crystal clear to me.

In a masterful presentation, Atul took us through the development of medicine from 1937 to today.  He described in some detail the limited capabilities most doctors had in the days before penicillin. He then told us about the explosion of knowledge in the field of medicine - Today, 10,000 known illnesses and 6,000 drugs.
He also explained, in part, why the cost of health care has increased exponentially… his example: arthritis – in the past it was treated with aspirin at 10 cents per tablet. Today, if medications fail, a patient can have a hip replacement for $40,000. This, and countless other options, were not available in the recent past. 10 Cents vs. $40,000 - healthcare costs have increased!
This is where the story begins to get interesting for leaders outside of healthcare. In the medical field, knowledge is driving complexity and complexity is driving specialization. Sound familiar? What are the implications for the rest of us?
In medicine, the single source, one stop, “Cowboy” as hero and sole provider is done – complexity and specialization won’t allow it. In the year 2000, it was determined that on average, a single patient in the hospital required 15 clinicians to respond to their case! Atul’s conclusion: what we need are not cowboys, we need pit crews.
I found his conclusion fascinating for several reasons. One is that in my book, The Secret of Teams, we visit a NASCAR pit crew looking for the keys to high-performance teams. Think about what a pit crew does. The members work together toward a common goal – winning the race.  To do this, each member brings his/her specific skill and expertise to the greater objective.
Isn’t that what we need in business and the non-profit sector? The challenges we face may or may not be life threatening, but nevertheless, the stakes are high. And, like in medicine, the amount of knowledge in our industries has also led to greater and greater specialization. This fact alone makes it difficult for the cowboys among us to be successful.
One of the preeminent skills that will be more and more critical as we move further into this century is the ability to build pit crews. Pit crews have a huge impact on which car wins. This will be one of our primary challenges as leaders. Those of us who can respond to complexity and specialization by building the best pit crew (a.k.a. High Performance Team) will have a competitive advantage. [GLS_Shield]
Read more about Atul’s perspective in his new book, The Checklist Manifesto.


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