"There's a show going down
tonight
It's the hottest show in town
Down to that Gypsy Cafe
Where the freeway turns around
Once a week or so you know
These people show up to play
And they're gonna be stars someday
They're gonna be stars someday!"
This morning I heard this guy on the radio who's music evoked those days. Amos Lee says he used to drive an hour to perform at an Open Mike venue in suburban Philly before Blue Note, a jazz label, signed him. Amos is no rookie. He carries his own polish that smells faintly of the stale beer and cigarette smoke-infused shag carpeting that decorates every Open Mike venue and sticks to more than the lining of the performer's guitar case.
Those of us who performed there mostly performed for each other. Some of us mugged for the mike, affecting Dylan, Donovan, Baez, or Buffy Saint Marie. Others closed our eyes to make ourselves invisible and invulnerable. Some had practiced long and hard while still others borrowed a guitar to perform. Someone always revived All Along The Watchtower. One crowd pleaser suffered from what I labeled John Fahey poisoning, finger-picking double time. There were dubious duets, sacrificial solos, soft rock, hard folk, and most everything inbetween.
I was a 'single acoustic artist,' or so my agent labeled me. A click above most in dedication and in skill AND I performed exclusively my own stuff. Never a cover. Rarely a stumble. I practiced a lot, long into the long evenings between.
I was, as Amos Lee labeled them, a jotter. I walked late night streets looking for inspiration, moving to the cadence of my boots, trusting my eyes, returning to try something by ear, then building up the story, the melody, and the hook. Eventually the tune would become performable or not, my inept transcription never withstanding. Never could, never did figure out notation.
Amos Lee reminded me of those sweet, tough days, the days before I learned to play this different-shaped guitar I play for you today. No Gypsy Cafe now. No enthusiastic scraggly half long hair setting the stage. They've outlawed stale cigarette smoke in public places and stale beer has become India Stale Ale. Those old men in short-sleeved dress shirts and straw dress hats no longer smoke sullenly in the back of the bar invaded once each week by kids seeking stars. And those world-weary kids we were, who in the hell even knows where we are now?
Here's to The Last Exit on Brooklyn and the Little Red Rooster, to Clinkerdagger's, The Mordor, and that place they tore down (what was its name?) to build that medical office building. All gone now. Everyone gone.
Here's a link to the sound we were all trying to make back then.
HereSo pleased and inspired to be transported back home again. Thank you Amos Lee!
In the last installment, I introduced the character behind management-ism. The 'can't manage what can't be measured' mindset that seeks metrics for measuring everything. Peter Block once asked the question, "If performance appraisals are so good, why don't we perform them on our spouses?" We don't perform them on our spouses because we have better ways to assess the goodness of that relationship. In absence of relationship, though, where we merely inhabit roles and perform process scripts, managing by such metrics might seem to make all the sense in the world. The management-ist sees no contradiction in employing 360 degree feedback strategies. The rest of us certainly do!
Within industrial-scale organizations, some new (read:old) paradigms are emerging. When Nike realized that the gas used in their air-cusioned sole was a volatile greenhouse gas, a movement started within the company. As Peter Senge explained it, three people—not executives, not powerful middle managers, but three rank and file employees—started a movement. They hosted lunch-time chats. They networked to gain influence. Their goal? A carbon-neutral Nike. Impossible? Certainly not on the corporate radar at that time. It is now. Nike's long-term strategy includes carbon neutrality. This started as a conversation among the powerless to become the stated goal of the whole organization!
How did THAT happen? You already know!
This is no isolated incident, though it might serve as the model or pattern for an under-recognized reality operating within even industrial-scale organizations. Innovation isn't top-down. Inspiration isn't either. The motive power that actually moves even the behemoths is organic, not mechanistic. Though the literature focusing upon processes and the improvement thereof leans heavily upon mechanical metaphor, the mechanism they fail to describe isn't mechanical, but organic. Quite remarkably human-scale. (Don't let the management-ist know, okay? They think they're in charge.)
If the management-ists aren't in charge, who is? As unlikely as this might seem, you are. I can't count the conversations I've had with individuals imbedded within industrial-scale organizations, where they cheerfully recount how they get away with things. These are not native sneak thieves, but deeply benevolent and loyal employees who routinely work the system so that system can work. The management-ists are blithely ignorant of the catastrophes avoided, believing, I guess, that their grand strategy is working more or less as they intended. It isn't. It never does.
The machine has remarkably little influence over this organic spirit. I have seen it thrive under the harshest conditions. In fact, harsh conditions seem to encourage it. Telling it "No!" won't deflect it much. This will just get its conniving imagination working harder.
The choice is not to work for someone else or work for yourself, you're always working for yourself, no matter who signs the paycheck. Working for yourself carries some ethical responsibilities, which can become lost in the overly-responsible dance management-ism embodies. In fact, everyone is managing all the time, it's not just the responsibility of the designated managers to manage. Where management becomes the sole purview of designated managers to do unto others and descends to the level of religious conviction, the net available management power within the organization plummets. These organizations are not certified organic. Where everyone understands that, regardless of what the mythodology claims, they are responsible for managing themselves first, interesting things happen. They happen as a resonance of a set of ancient ethical responsibilities that every human was born with but that the industrial, management-ist mindset scrupulously ignores. Kinda like what happens when organic methods reconnect a plant with its source of macro-nourishment. (Some just call this bullshit.)
One of these ethical responsibilities is:
Enough for today. More next time
Continuing the investigation of the secular religion of Management-ism started HERE, continued HERE and HERE ...
The last installment introduced Dr. Bob Ironside, an Internist who fled the managed care system to start a subscription-based health advocacy clinic, where his clients actively collaborate WITH him to maintain health rather than simply treat illness.
Dan Starr, in his comment on the third installment, noted that the HMO (Health MAINTENANCE Organization) concept originated in just this idea, a physician/client partnership focused positively, to maintain health and so reduce health care costs. It morphed into its opposite, where the object became negative, to reduce health care costs by aggressively "managing" allocation: dictating delivery terms, questioning diagnoses and treatment recommendations, and tightly limiting reimbursements to minimize costs. How maintaining health shifted into minimizing costs might serve as the general pattern defining the difference between the manager and the management-ist.
Management-ism thrives on homily and abstraction. Read any number of popular management books and you might reasonably conclude that management is more art than science, or so many commentators have concluded. The science seems rooted in something other than carefully considered propositions, relying heavily upon rumor, personal preference, and "consensus". It can't quite qualify as an art, either, as anyone who's formally studied art or lived as an artist quickly acknowledges. Some descriptions devolve into the even murkier realm of "leadership", which has all of the sparkle and promise common to personality cults.
In a Harvard-sponsored teleconference on leadership training, one of their B-school researchers admitted that not even Harvard knew how to train for leadership, and that their efforts would probably be best focused not on the B-school, but upon the Divinity School. She characterized B-school candidates as being more aggressive and self-centered than D-school students. Neither of these preferences are closely associated with good leadership. They are, however, common to forceful governance.
But how to transform responsible guidance or leadership into forceful governance? One must have a code, an ethic if you will, that justifies aggressive, self-centered acts. A force, ahem ... to be reckoned with. And that force was found in rules of thumb elevated to imperative, in promoting specific experiences into Best Practices, and otherwise mindless homilies into mind-numbing necessities. By creating an enforceable myth, a compelling story, and, above all, a plausibly believable fiction: Organization Man. (I imagine a kind of superhero who wears a spandex Brooks Brothers suit, high-luster wing-tips, and a sixties-style, narrow snap-brimmed hat. What Frank Loesser called "a Scarsdale Galahad, the breakfast-eating, Brooks Brothers type." Think Bob McNamara in his prime.)
Where to begin? Lets begin with what managers, according to their mythodology, can't do. They "can't manage what they can't measure." Moral: Anchor the organization to clear, objective, measurable metrics: SMART (Specific, Measurable, Achievable, Realistic, and Time-bound) goals. "Balanced" Scorecards. Focus upon predicting the future as the present reality. Tether everything to numbers. [Or, as everyone with much experience "managing" to these knows them, "NUMB-ers."] There, the perfect ambiguity cocktail, a steady diet of which utterly fogs reality.
One thing I noticed missing from Dr. Bob's description of his practice was the absence of any mention of specific, measurable, achievable, realistic, and time-bound goals. I'm certain his operation carries a few of these, as all businesses do, but they were nowhere apparent in the space between Dr. Bob and I. They were not foreground dominant. There, he seemed to be managing by instinct, by gut feel, by sparkly-eyed purpose. Exactly how he will satisfy his mission was not even germane to his realization of it. His clarity of purpose was obvious in his very presence. He was not managing his clinic, he was being it.
The professional management-ist is careful to maintain clear boundaries between self, others, and organization; he remains above all else "professional." He is not emotional—the constant focus upon the numb-ers helps there. Not introspective, but extrospective, taking cues from what he characterizes as external objectivity. He keeps score. He is fiercely loyal to his allies and fiercely allied against his enemies. You'll never see him sweat. He plays high-stakes poker. He knows the odds, the margin, the vigorish, and the game. He makes the rules when he can, bends them when he can't, and is tenaciously competitive; but a cardboard competitor, two dimensional, shallow. He's ruthless if he needs to be, generous when he must, heartless in the face of doubt, and stingy extending trust. He's convinced of the rightness of his cause, skeptical about your reliability, and cynical about his fellow man. He's negotiated a generous package for himself that will guarantee that he leaves "whole", whatever the contingency. He is, above all else, politically astute.
Quite a stereotype, huh?
In practice, the management-ist might well exhibit all of these patterns, but would never characterize himself in this way. Or, he might well exhibit none of these characteristics. He is, as the soothing voice-over in a Walt Disney short describes Goofy, "just your average guy looking to get by in the world." He's been infected with a perspective, though, one which comfortably justifies cold-hearted compartmentalizing, removing the person from the personality, leaving a caricature, an actor playing a role. An abstraction. Not present. Human absent soul.
He is curiously not curious. He can be quite dismissive toward anything he doesn't a priori understand and especially toward anything he cannot measure. If you cannot speak in his curious, limited dialect, it's YOU that will be judged clueless. As a class, they suffer from the one truly incurable disease: certainty. Consequently, they are addicted to risk-taking.
The seductions of this life are huge and, not surprisingly, measurable! Money. Position. Power. Authority. Security. Tenure. The costs, too, are enormous but fuzzy. Obligation. Responsibility. Accountability. Indictability. And, curiously, tremendous insecurity. (What do you do when you reach the top of your profession? Move to a gated community!)
Their world is abstracted by objective measurement. Like the mythical character who falls in love with the swan, the management-ist falls in love with his gauges, managing what he can measure and trying to measure whatever he aspires to manage. This might explain what transformed health maintenance into managed care. The gauges associated with managing care might just be as close as any management-ist could come to getting their arms around health maintenance. Health is subjective. Care can be metered by definite abstraction. It's all in the numbers, somewhere.
More next time. I've gotta go check the bumps on my head. ...
Last Tuesday, Amy and I convened a conversation. Sponsored by the local Chamber of Commerce to bring the business community together to consider: Surviving the downturn.
To our surprise, most reported no loss of lift, no panic. No one wore a barrel.
How does one take the temperature of a town? I'd spent the morning waiting with my dad while my mother was injected, inspected, reflected, and ultimately rejected for now: no obvious cause. Scheduled for continuing tests. Conclusions inconclusive.
Life, being holographic, presents herself in various equivalent disguises. Where ever I go, there she is. The phantom hitchhiker. "Say, isn't that the same woman we passed a hundred miles back?" Rod Serling authors every life.
So we convened, listening more than facilitating. Prepared to be changed by what we heard. What DID we hear? The conclusions inconclusive. More tests coming.
How to represent what we heard? One way is a word cloud- see above graphic. Another is word jazz, where the sound and shape and meter carry as much meaning as the words: see below-
I sat on the bar while Amy roamed. Almost twice the expected number arrived for con-ver-sa-tion. In a room unsuited to our purpose, we listened.
We convened. They did the talking.
How’s your business been impacted? Most said not at all. A couple claimed to call their clients, rather than drive to reach them now. One does her rounds on a Harley claiming that improves relationships. We’re all in the relationship business. How will we stay connected now? Here’s a tip: Fewer trips.
Real Estate professionals crowing: lots of inventory, prices fairly steady, though it is a buyer’s market now.
Tim Larkin reported that, when bank stocks went south, $100 million evaporated from this valley. This was mostly investment money, so no one’s missing meals except, perhaps those who rely upon donations from the better heeled and the restaurants might feel the pinch of people pinching penny stocks—so recently, real equity—and suddenly feeling poor.
On the other hand, fat commodity prices offset the markets here. The farmers haven’t made this much cash in a generation.
Then there’s the wine. Fine, we agreed, but not an economy.
Investors from West of the mountains are turning homes into “properties.” (That’s not much of an economy, either.)
And the construction workers at the Mall renovation left town until their payroll starts again. Where’d it go? No one knows.
Is the wolf at the door?
Focus now on value. Maybe the recession is only headline news. Stop watching the news and maybe we can choose to let the downturn pass our valley by.
Afterwards, quiet words:
“I think these people are delusional! In denial!”
“It’s early in the cycle yet.”
“This is all Jimmy Carter’s fault!”
“Pleased to meet you.”
“Charmed, I’m
sure.”
This posting continues the story started HERE and continued HERE. This third installment of my investigation of Managementism, the profoundly popular theology influencing everything from food production to health care, looks at one example of one practitioner who choose to step "Off The Grid."
In the last installment, I introduced a doctor, Bob Ironside, who, dissatisfied with the management of the health care system he was a part of, took personal agency to make his part work much better. I was sitting in an extremely comfortable room—I would not call it a waiting room, because it was clearly not designed for any activity as wasteful as waiting—for a chat with Bob about his life off the grid.
...I spent the few minutes after the receptionist left checking out the room. My chair was extremely comfortable. Three other matched chairs were, like mine, set around a large, low table, which held a bouquet of fresh flowers. Just behind me, on a sideboard, a Bose Wave Radio softly bled classical music. The windows to my right overlooked the mansions and forest just above NW Portland. I sipped my water, wondering where this conversation would start. And where it might lead.
Bob quietly opened the sliding panel and slipped into the room. I stood, and we shook hands like old friends before settling back into those comfortable chairs. I asked, "Bob, why don't I feel like a cow in a cattle car waiting for the conductor to call my stop?"
He explained that people don't open up when you treat them like cattle. He'd designed this clinic to not feel very much like a clinic because the traditional design shuts people down, and he needs people to speak freely there.
He went on to explain how his clinic works. "If Tim Russert had been our client, I'm convinced that he wouldn't be dead," he asserted. Bob's clients do not suffer catastrophic illness. Sure, they get sick, but in every case, he's seen the trouble coming and caught it in the earliest, most treatable stages. He helped one client, an ex-Olympic athlete, avoid a heart attack by carefully listening to his family's health history. Though he was in excellent health and showed no symptoms of heart disease, he ordered a battery of tests which showed that he did, indeed have heart disease, which he's treating before it became a catastrophe.
He shared several examples of clients who came to him dissatisfied with the diagnoses (and mis-diagnoses) they'd received (or not received) from their harried managed care physicians. Bob's great skill, I knew from my earlier relationship with him, was his exceptional ability to create rapport and really get to know his clients. He gets to know their story and can weave the intricate threads together. Perhaps just as importantly, his clients get to know Bob's story, too. He discloses a lot of his personal stuff as a part of his work.
This, it seems to me, is one hallmark of the self-manager. They do not aspire to an emotionally or intellectually or politically-neutral professional presence, but a disarmingly personal one. He is a very skilled and deeply respected practitioner, but he doesn't present himself as a Mr. Know-It-All. Instead, he creates a sense of joint inquiry, fueled by deep personal interest and, as I already knew but was about to learn even more profoundly, an uncommon advocacy.
His practice is now all about advocacy. When he refers a client to a specialist, he visits the specialist WITH them. He doesn't second-guess or upstage the specialist, and rarely says a word during these visits. If the client has questions, he lets the specialist answer unless explicitly invited into the conversation. Too many times, Bob noted, clients have questions after a specialist visit or don't understand that they don't fully understand what the specialist tells them. Bob forwards extensive patient history to each specialist beforehand, but admitted that specialists do not always make time to review them before the client arrives. Having been there, Bob can help position the puzzle pieces so the whole portrait makes sense to his clients, their specialists, and himself, too, making for much better-informed choices.
I was astounded! I wondered how he could possibly schedule those visits. (He also visits any client who's hospitalized.) Bob explained that client load has a lot to do with disabling a doctor's ability to fully advocate. Under managed care, he needed to carry a client load of about 3000 to make the numbers work, and even then, the numbers didn't work very well. Fully three-quarters of his staff then worked on billing and collections, and his performance was hampered by the normal intrigues that come with any large staff. Now he has a client load of about a hundred.
Incredulous again, I wondered, "So, you can do more with less, but what about the bottom line."
"It's much healthier than it ever was before," he smiled."
How does this work? People subscribe to Bob's service, paying an annual flat fee in advance. In exchange, Bob provides exceptional internist attention and health care advocacy. One of his clients, the Board Chair of a local hospital, was dissatisfied with the specialist Bob had referred him to at that hospital. "He was brusk, and 'all-knowing,' and we didn't feel like he'd delved deeply enough before diagnosing. So, I looked nation-wide, and ended up referring him to a colleague at the Mayo Clinic in Minnesota, who found a potentially life-threatening condition before it could threaten. Did Bob accompany his client there, too? You betcha!
This is an admittedly small-scale operation, but it's getting noticed by the HMOs. Bob's clients are healthy because they proactively attend to their health, rather than retroactively respond to often avoidable illness. The reimbursement for treating a single modest health crisis could pay for a lot of pro-active advocacy. Bob's practice doesn't replace the need for personal insurance coverage, but it quite effectively reduces the need to resort to it in crisis.
I asked Bob if he'd become a pariah in the local medical community, and he recounted a conversation with a local cardiologist at a recent meeting. "You're the envy of everyone practicing medicine in this town," his colleague confided. To those who might criticize Bob for taking an admittedly top-tier clientele, he responds that he's always treated the indigent and still does. Some of his clients pay noithing. Under the 'put on your own oxygen mask first' principle, Bob claims to be much more interested in volunteering his time now that he has time to volunteer. And now that his practice is supporting him well, rather than struggling to make ends meet. What was once mostly obligation has become a welcomed and more frequently engaged in opportunity.
I'm afraid that this posting has grown much larger than I intended, so I'll sign off here. There's more story to come. To be continued. ... ...
This post is the second installment in a series considering Management-ism, which I started here.
I first met Bob Ironside in the early eighties. He was then an Internist, working in a typical clinic he shared with a half dozen other docs. The waiting room was large enough to hold twenty or thirty patients. Staff worked behind a counter with a sliding glass window. A receptionist, several nurses, rows of shelves with patient files. The doctors saw patients in small rooms along a central hall, which was closed off from the waiting room by a door, guarded by one or another of the nurses. When a doctor was ready, a patient's name was called out, and the door to the examination rooms opened, and that patient was ushered down the hall.
In other words, a typical doctor's office.
The most important information, more important it seemed than the patient's condition, was the condition of their insurance, for upon entering the office, every patient visited the sliding glass window and discussed how they would be paying. I was using my insurance, so the receptionist photocopied my insurance card, calculating the co-pay amount while I filled out forms. I felt like I was purchasing a vacuum cleaner on the installment plan.
All typical doctor's office stuff.
I waited quite a long time, and since I had left work in the middle of the afternoon for the appointment, I noticed the time going by. Finally, my name was called and a nurse accompanied me to the examination room where she weighed me, took my blood pressure, and told me that the doctor would arrive momentarily. A few minutes later, Bob entered the room.
We chatted. His "manner" was casual and focused. He seemed genuinely interested in knowing about me. A few minutes into the examination, he explained that he was breaking a rule. What rule, I wondered.
"The Health Management Organization (HMO) monitoring this clinic," he reported, "has calculated that I should need to spend no more than seven minutes with any individual patient." he announced. "But I need at least a half hour to get to know anyone well enough to diagnose for them, so I break the rule, especially when the patient is someone interesting like you."
I felt flattered, but also felt the indignation Bob was spewing. He was genuinely upset. He continued, explaining that the geniuses at the HMO were not doctors but statisticians, accountants, auditors, and professional managers, none of whom had ever performed even the simplest diagnoses on any patient. I felt as oppressed as Bob obviously did.
He spent his half hour, made a recommendation or two, and we parted.
Over the following years, I followed Bob to a couple of other clinics, one's he and his colleagues started to try to sidestep the hated HMO. Over a decade later, he confided to me that he was not making it, that the management oversight had become simply absurd. Three quarters of the employees of his latest clinic worked not in patient care, but in billing and collections. Insurance companies further discounted standard charges by an average of 40% (for the service they provided processing their client's claims), and extended payment terms beyond 180 days. "How can anyone run a business with conditions like this? The efficiency experts claim savings by adding overhead to my organization, while the insurance companies walk away with terms favorable only to them. They're bankrupting me!" He also reported that insurance coverage seemed to encourage patients to be less responsible about their health, seeing health care as a right rather than a shared responsibility. He went on to say that he was thinking very seriously of simply going off the grid.
I'd not heard that term before, so he explained that his vision was to start a clinic where insurance would not be accepted as a valid form of payment, where patients contracted directly with him for his services, prepaying to eliminate billing and collections, in return for care without the management.
Fast forward a decade. I have been thinking about the off the grid model, and wanted to get a horse's mouth description of it, so I emailed Bob, asking for some face-time to chat. I spoke with his admin, and scheduled a late afternoon hour in his new off-the-grid office.
The offices of D2 are on the top floor of a medical office building directly across one of Portland's familiar tree-lined streets from Good Sam Hospital. I take the elevator up, and find the smoked glass door inscribed with the message "Admittance By Prior Appointment Only." A speakeasy doorbell adjacent. I ring the bell and the shadow of a young woman appears behind the door. The receptionist is not dressed like a nurse. She greets me by name, shakes my hand, and escorts me down a dimly-lit hallway, decorated with fine Oriental art, to a small sitting room overlooking the West Hills. Classical music softly fills the background space as she asks me if I'd like anything to drink. I order water and she brings a bottle and a glass, pouring from the bottle before closing the thin Japanese room divider panel to give me privacy while I wait for Bob to appear.
To be continued. This posting is long enough for today.
This entry might turn into a bit of a rant.
My question, How did we manage to f@#^ up our age-of-Aquarius opportunity in the world? When I look around, I notice that, not only is my generation worse off than the prior one, it's worse off than the one before that! The next generation seems to be even worse off than mine was. How did we manage to do that?
I just finished reading Michael Pollan's In Defense of Food, which continues his commentary, started in The Omnivore's Dilemma, on the sorry state of food production and distribution. He cites the close correlation between the introduction of what he calls Nutritionism and increases in everything from heart disease to attention deficit syndrome. Pollan speaks at length about the curious science of nutrition, which he claims more closely resembles a religion than a disciplined science. Post WWII, food became increasingly replaced by nutrition, typically vitamins and minerals added to a corn starch base and sold in lieu of food. This strategy enables industrial food producers to enjoy huge margins, but it ignored something important about food. Food apparently cannot be successfully separated from its context. We can't just distill a meal into a prescribed set of nutritional elements and expect to thrive. a) We don't yet understand what all the elements are and how they actually relate, and b) We have been misusing science to support the notion that we DO know what we actually do not. (Oh, and successfully lobbying to make this speculation the law of the land.)
... We have apparently been following a similar path in other areas, too. What Pollan noticed in the food system is at work in other areas of our society as well. His description of the Industrial Food System and the emerging Industrial ORGANIC Food System can pass for a reasonable description of our Managed Health Care system, too, and our Homeland Security System, as well as our business management system. What do these systems have in common?
Managers!
Not, as my daughter used to explain when she came home from grade school, "Self Managers," but what might be best described as "Other Managers." People who's primary job is to manage the interactions of others.
Who am I pointing my finger at? An old friend once confided an old bit of Brazilian folk wisdom: If it smells like dog shit where ever you go, check your own shoes first." Full disclosure: I have a degree in management. It seems as though I've been trying to unlearn ever since what I learned to earn my degree.
Okay, this IS turning into a rant. Perhaps a rant aimed at myself, but a rant nonetheless.
Peter Drucker claimed that the rise of the professional manager was the most significant achievement of the 20th century. I'm thinking that the replacement of the professional manager by the rise of the self manager might be the most significant achievement of this new century. If we can pull it off.
The professional manager is informed by a body of knowledge referred to as "management science," but like Pollan's description of nutritionism, management science is a curious kind of science, indeed. Based, as Stafford Beer noted a generation ago, more on authority, a priority, and tenacious belief than replicable science, and much more reductionist than holistic in perspective. My management training did little more than indoctrinate me into a way of thinking that separated me from some of my more important human capabilities, inducting me into a social class bred to be nourished by self sacrifice and rewarded according to my ability to encourage others to sacrifice themselves, too. For this effort, I was paid more than the rank and file.
Pollin labels nutrition science "nutritionism" because it became science in service not to nutrition or to humanity, but to short-term competitive advantage. Why would anyone create Wonder "helps build strong bodies twelve ways" Bread when the bread everyone was already eating built stronger bodies in innumerably more ways? Because if you take all of the complexity out of flour and replace some of it with simple, artificial ingredients, it won't spoil AND the producer can realize the mammon of all mammon, economy of scale! Big success.
In the same way that nutritionism misused nutritional science, manage-ism misuses science, employing it primarily as justification for what the machine already intended to do anyway. What's the primary problem with project management? Managers. Why does Scott Adams continually poke at the PM as the lowliest life form? People do not like to be managed. They are perfectly capable of managing themselves. But we've lost that knowledge somewhere. Somehow.
In conversation with an engineering manager recently, he was recounting how, early in his career, he would hop on a plane without any authorization, and fly to corporate headquarters to chat with the CEO. He noticed in that conversation that he had never done anything that outrageous or productive in his current job, that he'd "shut down" here. I asked him when he'd shut down, and he responded "nine years ago, about a week after I started working here." There, where management managed everything, creating a permission-focused culture where otherwise sentient adults ask their managers permission before doing anything.
In the next installment, I'll tell the story of a doctor who decided to go "off the grid" and stop accepting insurance claims as reimbursement for his services. His break-even patient load fell from 3,000 to under a hundred. His office staff went from 3/4 dedicated to billing and collection to two, with no one doing any accounting of any kind. His story describes how taking the manager out of managed care resulted in ... ahem ... more care.
Huff Puff.
