18th April 2019

“Get Better or Get Beaten”

Get Better or Get Beaten

I came across a fantastic TED talk this week by the American  surgeon, writer, and public health researcher Atul Gawande. He was looking at reducing the death rate of both mothers and children in an Indian hospital.

One of the questions he posed was how do people, specifically professional people, improve in the face of complexity? How do professionals get better at what they do? How do they become great? There are two views, he argues. One, the traditional one, says you go to school, you learn, you study, you practice, you learn, you graduate and then you go out into the world and you make your own way on your own. A professional is someone who is capable of managing their own improvement. He contrasts that with a second viewpoint which seems to have its origins in sport where they say “you are never done getting better. Everyone needs a coach”

Apparently sports coaching began as a very American idea. In 1875, Harvard and Yale played one of the very first American-rules football games. Yale hired a head coach; Harvard did not. The results? Over the next three decades, Harvard won just four times. Harvard hired a coach.

In the world of business, particularly in the UK, I don’t think we are even that sophisticated in our thinking, particularly in the SME (Small & Medium sized Enterprise) sector, where the number of people who would take a business qualification before setting up in business is very small. We seem to prefer just getting stuck in and making it up as we go along. The level of business leaders who regularly read business books is typically also very low. All of this is entirely understandable. Business founders and entrepreneurs are typically people of action. They are doers who will act first and think about it later. Ironically it is those very strengths that can prevent many entrepreneurs from ever building the scale of business their creativity and bravery deserves.

Gawande argues that eventually a professional’s rate of improvement slows and eventually stops. That is a problem. If a professional isn’t getting better and the environment is getting more complex, eventually they will become, at best, stuck, and at worst, find themselves going backwards. So it happens in business.

It is difficult to imagine a more ruthlessly competitive environment than business. If you and your business are not getting better you are slipping into the slow lane and you are being overtaken by your competition, by your market or by circumstances. So the real intellectual challenge is to understand how you can constantly improve.

Atul Gawande found the answer, not just for himself as a surgeon but also for a global health initiative that he led where they work on problems in the delivery of health care, including global childbirth.