Evening Sessions #2: Chaos Theory Management

What do medicine and management have in common?

Have a guess.

Go on.

I can wait.


Well, then I’ll tell you:


When I was at medical school I was told that by the end of my training the number of medical words I would learn would be greater than the number of words I would need to be fluent at French!


Everyday it would be one of my tasks to translate this new myriad of words into something resembling English for my patients.

Everything was going well until I started taking an interest in management and then I discovered it. I was shocked when I discovered it but it turns out there’s a separate language called ‘Consultantese’! From Business Process Re-engineering and Total Quality Management to BCG Matrices and Theories X,Y,Z there was a new world to bamboozle me.

You may be wondering where I’m going with this but in my last post about the Pareto Principle while reading (80/20 Principle by R Koch) about it I discovered its relationship with Chaos Theory . Now Chaos Theory has always sounded mysterious, mythical and alluring to me but I never really understood it. Many use the word chaos interchangeably with the word anarchy. So I thought I would avail myself of my ignorance and read a bit more about it and share.

Chaos Theory hinges on several propositions but one of the most basic themes is that of the ‘Butterfly Effect’ where small differences in our initial state can lead to vastly different outcomes and end points. We can use this to try and explain why 80/20 or Pareto imbalances occur because small differences in starting conditions are magnified over time as the universe magnifies these leading to emphatically different end points over time.

Richard Koch uses his examples of movies whereby 20% of movies released in a year account for 80% of box office sales. A movie is initially released ahead of time for a small group of critics to view. Those that get positive reviews will encourage consumers to watch those movies while those with negative reviews will have their attendance limited because who wants to see something with bad ratings? People tell their friends and demand means those positively rated movies get extended and widened theatrical releases while those with less positive reviews are limited and find themselves on Dvd (I prefer Blu-Ray!) much sooner.

Now I know its not always that simple. There are mountains of PhDs on this subject. My point is though when looking at processes as complex as those found in healthcare we often don’t have the time to focus on why bottlenecks and problems arise in our systems. I would boldly suggest that if we take the time to assess our systems we can find that fairly minor alterations could reap large dividends. This principle applies to the clinical management of patients as well as processes as in the Intensive Care the minor parameters are constantly being observed.

We can see trends and learn from what are seemingly freak occurrences. We can go back to the source and identify those factors that give us advantages and ensure these happen more often than not and purposely integrate them into our systems and processes.

Hidden beneath unpredictability is a source of unnerving regularity in how the universe operates and we can use this to our advantage.

Just ponder that.

Dr Saif Abed

CEO and Co-Founder

Abed Graham Healthcare Strategies Ltd



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