Cowboys and Pit Crews : The New Yorker

In the UK Cowboy has an alternative negative meaning so for Cowboy in the article above read Lone Ranger.

The article is a speech given at Harvard Medical School to graduating students.  The speaker describes how the number of people involved in patient care in the USA has grown from 2.5 full time equivalents per patient in the 1970's to 15 at the end of the 1990's and probably more today.  Contrasting the enormous range of treatments available the speaker describes how 2 million Americans pick up preventable infections in hospital, 40% of heart patients and 60% of asthma patients are receiving incomplete or inappropriate care, and 50% of major surgical complications are avoidable.

After highlighting that the patient's experience is that clinicians are amazing he concludes that there is little consistent sense that all these people come together to provide an actual system of care.  The reason being that doctors are trained to be Lone Rangers, but patients need Pit Crews.  The result is a range of outcomes where the best results do not occur where the most money is spent.

What has this to do with engineering?

Lone Rangers work alone deciding what is best without reference to others, doing things their way.  Pit Crews are tightly knit teams that work as one all dependent on each other, no room for "free spirits".

Project performance and project outcomes are a team effort.  Are you a Lone Ranger or a member of a Pit Crew?  Who in your team is going to forget to tighten the wheel nut or put the fuel in?

Interestingly the speaker met a real Cowboy.  The real ones today herding cattle work in tightly organised teams each assigned specific roles and constantly communicating.  They have protocols and checklists for the unexpected. 

So much for the wild west.  Do you think construction is still  the wild west?