Quote Of The Year

Quotes Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Tuesday, October 21, 2014

Edward Gough Whitlam - My Thanks


For getting rid of conscription (yes I was sucked in), providing major changes to health and education (yes I really benefited) and getting rid of the death penalty - many thanks!

We won't see his likes again I believe. The meanness we now see in public policy just shows how badly we are presently led - IMVHO. We can care and fund things - but no one wants to try!

Pity about that.



Terry Hannan said...

David, your words regarding Gough sound a resonance with a communication I received yesterday about one of the great leaders in Health Informatics-Dr Clem McDonald. Here it is.

"This story grew out of years of watching Clem McDonald in action, famously productive, while others seemed to spin their wheels. It is much the same message as the Cathedral and the Bazaar.

Clem and another group are faced with the same challenge: build a bridge across a canyon.

The other group — like most of us would — gathers engineers, draws up specifications, and begins planning on how the bridge should be constructed properly. Meanwhile, Clem pulls a box of dental floss out of his pocket, unwinds it, and throws it across the canyon. Almost immediately, he's got something across the canyon. It's only floss, but it's there — end to end.

The other group is arguing about whether the bridge should be a beam, suspension, truss, or arch bridge. Clem starts layering paper mâché onto the floss.

The other group has finally decided on a suspension bridge and begins preparing the materials according to specifications. Clem has people walking across his paper mâché bridge.

The other group realizes that they would probably be better off with a truss bridge, begins discussions on the new specifications, and then realizes that they are too far over budget and the project is shut down. Clem has people driving across his bridge.

The other group finally creates their version of the bridge, only to realize it doesn't reach over to the other side where they initially intended it to!
The Lesson
Whenever possible, start with the floss. See the solution through end-to-end, since this is often the best way to understand the problem and often informs the next pass at the solution. In the end, it is rare that we fully understand the problem until the third iteration of the solution.
Be agile, open to corrections, and iterate on your solutions. But, most importantly, take action."

Anonymous said...

As much as I appreciate the intent of the anaolgy, I am afriad the envirnment the bridge needs to operate in is not mentioned, paper mache might be fine and dandy in say A desert setting in Chile, however it would quickly fall aprt in a Laurel forest setting, but then again perhaps the forest was destroyed to make the paper mache.

We need a balance between the two extremes and break the very lucritive business model that keeps the stangnate software developers and large scale implementers from allow a more fluid and creative approach IMHO
Gough, you are a giant amoungst mear mortals, long will history remeber you RIP

Bernard Robertson-Dunn said...

As an engineer I can relate to the bridge building analogy. However there are a number of other relevant issues.

The first is that the engineers try and build what they have been asked to build. They don't ask questions like:

should we be building a bridge or something else?

where should the bridge start and finish?

The problem as I see it is not how to build a bridge but how to get from one place to another, without necessarily understanding where the start place and/or the end places are or should be.

However, the approach of trying out different solutions in order to better understand the problem is a good one.

Sometimes the problem that delivers the most value when solved turns out not to be how to get to the other side of the canyon but where is the best place on this side of the canyon to be? In which case the solution may be a road or a tunnel, in completely the opposite direction from the bridge over the canyon.

Building and maintaining a bridge can be a very expensive and risky thing to do. It also severly constrains future flexibility.

On the other hand, seeing the tracks where people walk and turning them into pavements and roads can be far better. So can the construction of new roads to new places - all incremental changes that people can gradually become used to.
And before this analogy gets stretched too far, the real problem is not about bridges or roads, it’s about where people need or want to be.

Grahame Grieve said...

The bridge metaphor - I wrote about this: http://www.healthintersections.com.au/?p=221