🧭 A guided walk through the hidden work our systems quietly transfer to people.
The last time I changed family primary care providers, I tracked my time.
Nearly 200 hours.
At first, I thought I was measuring the cost of changing doctors.
Now I think I was measuring something else entirely.
Not healthcare.
Not administration.
Capacity.
Benchmarking has a way of changing the questions we ask.
Instead of asking, “Why was this so difficult?” I found myself asking something much more useful.
What, exactly, was I producing during those 200 hours?
Pause there for a moment.
Not what the healthcare system was producing.
What was I producing?
How much of my work created value?
How much simply kept the system moving?
As scientific thinkers, collaborators, innovators, leaders, and practitioners, we spend a great deal of time studying systems.
Not because systems are perfect.
Because they teach us where to look.
So let’s take a walk.
Not through a hospital.
Not through a factory.
Walk through yesterday.
Where did work quietly move from the system…
…to a person?
Where did someone compensate for a process that should have worked?
Where did someone become the workaround?
Don’t solve it.
Just notice it.
One of the habits quality management taught me years ago was this:
🔍 Observation comes before judgment.
If I walk onto a manufacturing floor convinced I already know the answer, I’ve stopped learning before I’ve even begun.
The same is true everywhere else.
- Healthcare.
- Education.
- Government.
- Business.
- Volunteer organizations.
- Our own homes.
The terrain changes.
Human systems don’t.
That’s why reflection matters.
Lessons learned don’t begin with answers.
They begin with paying attention.
Lean gives us language for what we often observe.
🗑️ Muda.
Work that creates no value.
🪨 Muri.
Work that asks more of people than they can reasonably carry.
⛓️💥 Mura.
The inconsistency that quietly forces people to compensate.
Most organizations can define those words.
The challenge isn’t vocabulary.
The challenge is recognizing them after they’ve become normal.
So here’s another question.
What have you stopped noticing?
Lately, I’ve been asking that question in my own life.
Not because healthcare is unique.
Because it magnified a pattern I already recognized from years spent improving organizations.
When people repeatedly compensate for the same friction, we tend to celebrate their commitment.
Rarely do we stop to ask what condition inside the system made that commitment necessary in the first place.
That’s where my curiosity lives.
Not in assigning blame.
In understanding conditions.
Because systems reliably produce the results they are designed—or allowed—to produce.
And if we want different results, we have to become students of the conditions that create them.
Now pause again.
Where do you see this?
Who on your team quietly carries work that doesn’t belong to them?
What process depends on one person remembering something everyone else has forgotten?
Where has adaptation quietly become expectation?
Don’t look for the biggest problem.
Look for the most familiar one.
Those are often the hardest to see.
I’ve never walked into an organization without finding waste.
Not because the people weren’t committed.
Not because the leaders didn’t care.
Because every living system produces it.
Continuous improvement was never about eliminating every imperfection.
It was about becoming better at seeing what we’ve stopped noticing.
That has been true everywhere I’ve worked.
It’s true in my own life.
And it’s true every time I sit down to write one of these essays.
So this week, try one experiment.
Choose one recurring frustration.
Instead of asking,
“Who owns this?”
Ask,
“What conditions produced this?”
Then stay curious just a little longer.
You may discover that the most valuable improvement isn’t making the work move faster.
It’s returning capacity to the people doing it.
Sometimes that’s where the real work begins.
Slingshot Designs 