isn't this the same argument from "The Mythical Man-Month" by Fred Brooks (1975)? Brooks argues that adding more programmers to a project leads to increased communication overhead and makes it harder to coordinate efforts and thus resulting in a counterproductive effect.
Ah yes that too. There's a history of arguments around communication issues, though my POV is that even assuming proper communication and resources the sheer increase in information from both the market and the other internal areas makes it much more cognitively costly and take sup information processing space
Is that essentially Conways Law? The idea that products designed by organizations will reflect the structure of the organization that designed it due to bottlenecks in communication between it?
Conway's law is more that org systems mirror their communication structures. Which definitely plays a part in how the organisations differ from each other, though not the same as looking at how this imapcts the efficiency per se as a result of their success (scale).
It's helpful to look at how bureaucracy evolved--what problems was it adopted to solve?
I see three. Size. Change. Diversity.
First two points are not controversial. First, size. "Bureaucracy" historically comes from oddly large orgs--military, church, shipbuilding--and was borrowed by other organizations. To get big, you need formal procedures that replace old customary or face-to-face procedures. Certain big organizations began to capture economies of scale and scope--in industry, government and social life--which led to the predominance of large orgs we see today.
Second point is change. The bureaucracy can work to bracket and in some ways mitigate changes in the modern economy. Its size in other words lets it provide insurance against unpredictable shocks. It can push its people and capital to smooth out short-term unpredictability and strategically navigate medium-term unpredictability. From the standpoint of the individual consumer the bureaucracy can provide a regular product or service even in the face of change. From the standpoint of the worker, the bureaucracy can offer a somewhat regular lifepath--with set daily activities, seasonal rituals, career progression, etc.
The final point, diversity, may be more controversial. I saw bureaucracies especially in social life arising to deal with exceptionally diverse groups of people. Cities exploded post 16 C--huge anonymous places filled with migrants. The experience of this diversity was uncomfortable. Bureaucracies helped to smooth this away. Instead of dealing with customary work relations you had written, explicit work relations backed up by formal supervision. Instead of dealing with willy-nilly social life, you had clubs with written rules and fines for breaking those rules. These let people (well, men) of different political, religious and geographic backgrounds come together temporarily.
I agree with this broadly. It's more that for some type of businesses the formalisation is a net positive at scale, with the added effects of making people happier at work and slarymen etc. Today though we see it get out of hand a bit. Out largest companies are essentially old countries. The govt departments too. That makes the diversity part of it, in terms of aims and not social engagement, harder.
Large hospital groups, as a physician employed in one, are barely trudging on. Our hospital was recently acquired by a large conglomerate and it added an entire new layer of bureaucracy headquartered in a city 200 miles away.
Not a single local administrator was fired, they just had another layer added on top. Meanwhile, the bedside is collapsing. Rules created by medicare administrators and enforced by regional and local administrators means patients die of infections we are not allowed to treat, lest the administrators are angry. Rules placed by billing departments means doctors can no longer tell NPs/PAs that what they're doing is wrong/harmful, because the only real harmful thing in a hospital is violating an administrator's rules. Death, life, outcomes? Matters not.
I hear 50-60% of our hospitalists are refreshing their CVs. Meanwhile the CEO sent an email saying the hospital group had a 5,000,000$ loss instead of a 2,000,000$ profit (how a system with 5,000 beds has such tight margins, I don't know.) What did the CEO blame? 'Staff pay'.
Doctors and nurses saw the writing on the wall. Smaller hospitals are paying triple.
That is horrifying, and interesting. Because this is an instance where clearly economies of scale should work, but by our insistence on added bureaucracy we have overcome its benefits.!
Aug 14, 2023·edited Aug 14, 2023Liked by Rohit Krishnan
They absolutely don't work; not in medicine.
Entire specialties have been degraded by regulatory bodies attempting to enforce algorithmic monotony. Cardiology has been turned into the most algorithmic field, and the poor outcomes are visible.
They created a nice algorithm with debatable evidence and presented it as fact. Then they unleashed an army of NPs/PAs and told them the algorithm is gospel. My core memory now that I exceed my first year practicing medicine in the US is my MD/pHD boss getting told by a Nurse Practitioner she knows more medicine than him as she confidently applied the algorithm he tried to get her to back off from. As expected, patient had a stroke.
In my big hospital? No recourse. Heck, the cardiologists who 'oversee' the NP lament not being able to discipline her because it has to go through an army of administrators who think they know medicine better than doctors. (Everyone knows medicine better than us, it seems).
In a small hospital? Discipline is at the bedside, not in an HR office. When systems outweigh the individual in a hospital, people die. (Also when the individual outweighs the system, to be fair) You need a very finely tuned balance.
It gets worse. Productive members of the organization are locked out of these meetings, which are by nature non-productive.
Our hospital has a private pulm/crit group that they contract. These docs work 12 hours a day for 6 weeks; with only 4 days off total. They're paid handsomely for this work, but the hours are still insane. One of the doctors in that group also makes a point to sit on a bunch of committees to have the ICU's voice heard. He says if he didn't spend these 2-3 hours a day, the ICU would get destroyed by admin.
This is the ICU that is forbidden from doing basic ICU stuff by administrators leading to poorer outcomes. A represented one. A non-represented ICU likely does worse. I asked the good doc how he has time to do all this crap, and he matter of factly answered 'Some things I have to sacrifice, like sleep'. A 49 year old man who I mistook for a 60 year old.
You describe the problem very well (apart from maybe attributing Dickens to Tolstoy!) There are not obvious solutions but I wonder if you have read "The Living Company" by Arie De Geus. Fascinating because he looks at why long lived large companies have survived when most have lifespan shorter than the average human. Not a perfect solution but an interesting question?
In software terms, it's one thing to create and launch a Minimal Viable Product but it's quite a different thing to develop something more complex at scale and sustain it. But to your point, big companies can redirect resources into smaller teams to create some amazing things, that's one advantage of size, experience and leveraging existing relationships.
A short version is that larger organisations have many more moving parts and purely from individuals who have more degrees of freedom to move this results in higher entropy. Quite often this means even when there are multiple teams trying to do things which have ostensibly similar processes or outputs, this doesn't mean that making them behave exactly the same is useful, beyond satisfying our need for having things work the same.
A short version is that larger organisations have many more moving parts and purely from individuals who have more degrees of freedom to move this results in higher entropy. Quite often this means even when there are multiple teams trying to do things which have ostensibly similar processes or outputs, this doesn't mean that making them behave exactly the same is useful, beyond satisfying our need for having things work the same.
isn't this the same argument from "The Mythical Man-Month" by Fred Brooks (1975)? Brooks argues that adding more programmers to a project leads to increased communication overhead and makes it harder to coordinate efforts and thus resulting in a counterproductive effect.
Ah yes that too. There's a history of arguments around communication issues, though my POV is that even assuming proper communication and resources the sheer increase in information from both the market and the other internal areas makes it much more cognitively costly and take sup information processing space
Is that essentially Conways Law? The idea that products designed by organizations will reflect the structure of the organization that designed it due to bottlenecks in communication between it?
Conway's law is more that org systems mirror their communication structures. Which definitely plays a part in how the organisations differ from each other, though not the same as looking at how this imapcts the efficiency per se as a result of their success (scale).
It's helpful to look at how bureaucracy evolved--what problems was it adopted to solve?
I see three. Size. Change. Diversity.
First two points are not controversial. First, size. "Bureaucracy" historically comes from oddly large orgs--military, church, shipbuilding--and was borrowed by other organizations. To get big, you need formal procedures that replace old customary or face-to-face procedures. Certain big organizations began to capture economies of scale and scope--in industry, government and social life--which led to the predominance of large orgs we see today.
Second point is change. The bureaucracy can work to bracket and in some ways mitigate changes in the modern economy. Its size in other words lets it provide insurance against unpredictable shocks. It can push its people and capital to smooth out short-term unpredictability and strategically navigate medium-term unpredictability. From the standpoint of the individual consumer the bureaucracy can provide a regular product or service even in the face of change. From the standpoint of the worker, the bureaucracy can offer a somewhat regular lifepath--with set daily activities, seasonal rituals, career progression, etc.
The final point, diversity, may be more controversial. I saw bureaucracies especially in social life arising to deal with exceptionally diverse groups of people. Cities exploded post 16 C--huge anonymous places filled with migrants. The experience of this diversity was uncomfortable. Bureaucracies helped to smooth this away. Instead of dealing with customary work relations you had written, explicit work relations backed up by formal supervision. Instead of dealing with willy-nilly social life, you had clubs with written rules and fines for breaking those rules. These let people (well, men) of different political, religious and geographic backgrounds come together temporarily.
I agree with this broadly. It's more that for some type of businesses the formalisation is a net positive at scale, with the added effects of making people happier at work and slarymen etc. Today though we see it get out of hand a bit. Out largest companies are essentially old countries. The govt departments too. That makes the diversity part of it, in terms of aims and not social engagement, harder.
I'd also add hospitals.
Large hospital groups, as a physician employed in one, are barely trudging on. Our hospital was recently acquired by a large conglomerate and it added an entire new layer of bureaucracy headquartered in a city 200 miles away.
Not a single local administrator was fired, they just had another layer added on top. Meanwhile, the bedside is collapsing. Rules created by medicare administrators and enforced by regional and local administrators means patients die of infections we are not allowed to treat, lest the administrators are angry. Rules placed by billing departments means doctors can no longer tell NPs/PAs that what they're doing is wrong/harmful, because the only real harmful thing in a hospital is violating an administrator's rules. Death, life, outcomes? Matters not.
I hear 50-60% of our hospitalists are refreshing their CVs. Meanwhile the CEO sent an email saying the hospital group had a 5,000,000$ loss instead of a 2,000,000$ profit (how a system with 5,000 beds has such tight margins, I don't know.) What did the CEO blame? 'Staff pay'.
Doctors and nurses saw the writing on the wall. Smaller hospitals are paying triple.
That is horrifying, and interesting. Because this is an instance where clearly economies of scale should work, but by our insistence on added bureaucracy we have overcome its benefits.!
They absolutely don't work; not in medicine.
Entire specialties have been degraded by regulatory bodies attempting to enforce algorithmic monotony. Cardiology has been turned into the most algorithmic field, and the poor outcomes are visible.
They created a nice algorithm with debatable evidence and presented it as fact. Then they unleashed an army of NPs/PAs and told them the algorithm is gospel. My core memory now that I exceed my first year practicing medicine in the US is my MD/pHD boss getting told by a Nurse Practitioner she knows more medicine than him as she confidently applied the algorithm he tried to get her to back off from. As expected, patient had a stroke.
In my big hospital? No recourse. Heck, the cardiologists who 'oversee' the NP lament not being able to discipline her because it has to go through an army of administrators who think they know medicine better than doctors. (Everyone knows medicine better than us, it seems).
In a small hospital? Discipline is at the bedside, not in an HR office. When systems outweigh the individual in a hospital, people die. (Also when the individual outweighs the system, to be fair) You need a very finely tuned balance.
Algorithmic monotony is a great phrase
It gets worse. Productive members of the organization are locked out of these meetings, which are by nature non-productive.
Our hospital has a private pulm/crit group that they contract. These docs work 12 hours a day for 6 weeks; with only 4 days off total. They're paid handsomely for this work, but the hours are still insane. One of the doctors in that group also makes a point to sit on a bunch of committees to have the ICU's voice heard. He says if he didn't spend these 2-3 hours a day, the ICU would get destroyed by admin.
This is the ICU that is forbidden from doing basic ICU stuff by administrators leading to poorer outcomes. A represented one. A non-represented ICU likely does worse. I asked the good doc how he has time to do all this crap, and he matter of factly answered 'Some things I have to sacrifice, like sleep'. A 49 year old man who I mistook for a 60 year old.
You describe the problem very well (apart from maybe attributing Dickens to Tolstoy!) There are not obvious solutions but I wonder if you have read "The Living Company" by Arie De Geus. Fascinating because he looks at why long lived large companies have survived when most have lifespan shorter than the average human. Not a perfect solution but an interesting question?
Ha good point thanks! And indeed it's a bit of an obsession, another one where I looked at it here - https://www.strangeloopcanon.com/p/the-price-of-immortality
Since you reference the Sante Fe institute in an earlier article, you've probably read https://www.goodreads.com/book/show/34113939-scale. I really enjoyed it.
I have. First got introduced to complexity works through their papers, including Geoff West.
In software terms, it's one thing to create and launch a Minimal Viable Product but it's quite a different thing to develop something more complex at scale and sustain it. But to your point, big companies can redirect resources into smaller teams to create some amazing things, that's one advantage of size, experience and leveraging existing relationships.
The modern glut of twitter clones are a perfect case study here
Would you mind expounding upon how Entropy impacts organizations?
A short version is that larger organisations have many more moving parts and purely from individuals who have more degrees of freedom to move this results in higher entropy. Quite often this means even when there are multiple teams trying to do things which have ostensibly similar processes or outputs, this doesn't mean that making them behave exactly the same is useful, beyond satisfying our need for having things work the same.
Thank you. I love tying the entropy into everyday life, so I find this very interesting.
Thermodynamics is life 💪
Do you have any good papers on this topic?
None. Only things I've pulled together.
A short version is that larger organisations have many more moving parts and purely from individuals who have more degrees of freedom to move this results in higher entropy. Quite often this means even when there are multiple teams trying to do things which have ostensibly similar processes or outputs, this doesn't mean that making them behave exactly the same is useful, beyond satisfying our need for having things work the same.