I recently listened to an interesting episode of The Ezra Klein Show. In the episode, Ezra interviewed Dr. Leana Wen, the Health Commissioner for Baltimore. The conversation is about public health and Dr. Wen’s approach to combating serious challenges in some of Baltimore’s most troubled communities.
Here’s an interesting new data point I learned from Dr. Wen:
Even though 97% of health care costs are spent on what happens in the hospital, less than 10% of what determines how long someone lives depends on what happens in that hospital.
Our fancy medical innovations play a surprisingly small role in longevity
Pretty wild, right? Think about someone rushed to the hospital after having a heart attack. Maybe they receive a stent. Maybe they undergo a bypass operation. They’ll receive some pharmaceutical cocktail. All of that treatment will likely save that person’s life. But when it comes to how long that person will live…the hospital treatment is nearly inconsequential.
Do you know what promotes longevity, instead of the hospital intervention? The right diet, coupled with the right activity level, coupled with stress avoidance. Stents and heart surgeries save a lot of lives. Even more lives are saved by tens of millions of people making healthy lifestyle choices before they ever have to fight heart disease.
This example is personal for me. My dad had a heart attack and triple bypass surgery when he was a young man. Through the use of medication, and improvements in diet and exercise, he’s in great health today.
I have a visceral reaction to the heart disease epidemic in the United States, in large part because I watched my dad navigate through it. Ultimately, he was saved through pioneering surgical and pharmaceutical innovations. Seeing the depths of the disease, followed by the “cure”, made a deep impression on me.
I would not have had anywhere near that impression if my dad had adopted a healthier lifestyle from the beginning, and avoided his heart disease struggle entirely. That’s the nature of prevention. Because the disease would never have been there, I would never have been forced to reckon with its reality.
The problem with prevention? It makes for a crappy story
Human beings are wired to respond to story. That’s pretty much how we live our lives, narrating our own story as we go along.
In a sense, prevention is the anti-story. When it comes to health, prevention, in the best way possible, robs us of a painful story that might have had a profound impact on us. If life is built around story-telling, it’s difficult to appreciate the full value of the mechanisms we use to prevent harm, because the corresponding stories never materialize.
When we talk about public health in the United States, what‘s the single most pervasive topic? Health insurance. And that’s strange, because health insurance is one part of a broader health care system that, in totality, explains a small fraction of our longevity.
Why do we focus so much on health care, if it explains such a small fraction of our total health? Because prevention doesn’t offer the foundational elements of story-telling: conflict and resolution. The nature of prevention is that we avoid the conflict in the first place.
The whole health care infrastructure is built around resolving health-focused conflict. Given our story-based hard-wiring, of course we respond more powerfully to discussions of health care. Plus, we have politicized public health to such a degree that, of course we focus on a lightning rod like health insurance.
Regardless of the cause, our focus on health care distracts us from a broader discussion of public health. And this broader discussion should center around prevention, with emphasis on the lifestyle elements that dictate a preponderance of our total health.
Prevention is boring, so you get little credit for it at work
Now we get to the question in the title of this post: are you a problem solver? Or a problem preventer?
It’s much sexier to be a problem solver. You see that description all over people’s LinkedIn profiles and resumes. Problem solving implies a deft intellect, a resourcefulness. Problems attract a lot of attention. Solutions bring a lot of acclaim.
Being a problem preventer is much more boring. People see the expected, repeated, competent output from a problem preventer and think little of it.
Steve Jobs. Howard Schultz. Jack Welch. Lee Iacocca. These are problem solvers. We know their names because of it.
How might you prevent problems at work?
- You spend a little extra time testing your design, making sure it’s robust against modes of failure other people might ignore.
- You include an appendix with your report, where you anticipate and address questions that otherwise could create costly confusion.
- You painstakingly document your customer’s most mundane pain points, giving you the best chance to delight them in the future.
Often, these techniques not celebrated, or even acknowledged, at work. In many cases, they’re actively derided. They’re a “waste”. You’re over-engineering your design. You’re wasting your time writing an appendix no one will read. You’re bothering your customer, instead of doing real work in the office.
Selling a cure is a lot easier than selling a preventative, unless the preventative is perceived as a cure or curative aspects of the preventative are emphasized.
Prevention is a tough sell. If you do want to sell it, focus on what the prevention cures:
- Point to an example where a predictable failure crippled one of your products.
- Point to an example where a report created confusion and led to costly delays or redundant work.
- Point to an example where insufficient understanding of a customer’s challenge led to their dissatisfaction with your offering.
You can be a problem solver; just don’t forget problem prevention either
We’re not talking about an either/or proposition here. You can advertise your problem solving skills. People care about that. It shows up often on resumes for a reason.
What I recommend, though, is to not forget about problem prevention. It’s a two part battle. First, acknowledge where a little bit of effort can go a long way toward preventing a costly failure. Second, broadcast the value of these seemingly superfluous efforts. This is a change initiative. Like with public health, we need more people to think about, and value, prevention.
The real difficulty with the change element is the lack of story. With effective prevention, we avoid the conflict that would have been at the heart of our story. There’s no need for a resolution when things are going smoothly from the beginning. That’s why we need to articulate the kinds of conflict that could have happened. Celebrate the avoided losses just as much we celebrate the visible wins.
It would be great if everyone in leadership was a mature, patient, disciplined thinker who innately understood the value of problem prevention. That’s not always the case, though. It’s incumbent on us, as owners of our own careers, to surface the value of problem prevention. We need to be as capable in preventing problems as we are in solving them. And we need to make sure our organization appreciate those capabilities.