Don´t hire me!

According to an estimate made by Institute of Medicine, 230.000 to 284.000 people die in US annually due to iatrogenesis. Iatrogenesis is the term for harm caused by medical treatment (or if the harm is greater than the benefit of the treatment). Until 1846 when Ignaz Semmelweiz found out that disinfection seemed like a good idea, and before 1928 when Flemming discovered the penicillin, iatrogenesis was pretty much the main story if you got sick or hurt and were unlucky enough to end up in hospital. The word is Greek and means “brought to you by healer”, (iatro means healer). Examples of iatrogenesis are: becoming heavily addicted by a pain killer, get surgery on the wrong knee, or surgery even though you don´t need it. In Antifragility Taleb calls this phenomenon naïve interventionism and describes its fragilizing effects in a variety of disciplines, economics, politics, parenting, media etc. Humans are antifragile, and human systems can be too, why we sometimes rather should refrain from naïve interventionism and instead rely on the systems to correct or “heal“ themselves. And if surrounding stakeholders are incentivized and earn something themselves from doing the intervention, the ratio of, for example surgeries, could be heavily skewed. (Which is proven to be the case).

Let me coin a new term, sýmvoulogenesis, “brought to you by consultant”, which would be iatrogenesis within the realm of business. If you have troubles to get your things right within your organization and decide to make a reorganization, you have about the same odds as the patient had pre-Semmelweiz. According to the article Getting re-orgs right in Harvard Business Review about 80% of reorgs fails to deliver the planned value within time, 10% are messing it up even more. HBR suggests a number of reasons as to why the re-org fails, such as people resistance, people leaving, insufficient resources devoted or unforeseen events. What I learned is that third parties often are brought into the game to support in the re-org, the value creation is often generic (economy of scale and/or specialization) despite the uniqueness and context dependence of organizations, and it always starts in structure (typically org charts or capability maps).

What we can learn from Ken Wilber and his Integral theory is that values, behaviors, culture, and structural aspects of the organization all must be addressed coherently for a successful reorganization, it´s not enough with merely structural changes. And with generic frameworks and value creating paradigms a la fancy high end consultancy, the risk is very high you are ending up amongst the 80% failing, or the 10% messing it up even more.

So.. if big reorgs seem to fail, why are we still doing them?

One thing is clear, and that is that we are biased towards doing stuff (which often is a good thing). We seldom got rewarded for not doing stuff, we want to show leadership through action! As little as the high paid surgeon will refrain from doing that spine-surgery and send the patient home with pain killers, will I as a consultant suggest keeping the intervention to bare minimum. But I probably should! Or at least more often than I think. Because antifragile human systems tend to self-organize and resolve issues themselves, as long as we stick our command-and-controlling fingers out of the jar. And as antifragile systems becomes stronger through stressors, we probably instead of naïve interventionism (doing harm with the intent of doing good), should try the opposite (doing good with the intent of doing harm). If you take the human body as an example here, we strengthen it by stressing it through training, sauna, cold baths, etc. One example that Taleb suggests in the digital domain is enrolling hackers to stress-test the systems in order to find the weak spots and tighten them. The founder of the company I´ve been working at for 18 years, Ingvar Kamprad, had a tendency to create crisis regularly to strengthen IKEA.

So, if you want to do a reorg and want to avoid sýmvoulogenesis, don´t hire me in the first place! Unless you want me to come in and stage a little crisis or so, that is!