Small, a great destination

Rework - Why Grow?
Illustration from Rework

In their book Rework, the guys from 37signals make a compelling argument for staying small in a chapter called “Why grow?” My favorite quote from that chapter:

Small is not just a stepping stone. Small is a great destination in itself.

And this isn’t just empty talk from someone trying to sell books, this is how they actually run the company. From a recent article on Fast Company, here is 37signals CEO Jason Fried (@jasonfried):

I’m a fan of growing slowly, carefully, methodically, of not getting big just for the sake of getting big. I think that rapid growth is typically of symptom of… there’s a sickness there. There’s a great quote by a guy named Ricardo Semler, author of the book Maverick. He said that only two things grow for the sake of growth: businesses and tumors. We have 35 employees at 37signals. We could have hundreds of employees if we wanted to–our revenues and profits support that–but I think we’d be worse off.

This is kind of a follow up to yesterday’s post, Living life for a living, which got me thinking again about the 37signals philosophy. What it really comes down to, it seems, is the difference between a businessperson – who wants to run a business that makes money; big is better – and a person in business – who wants to build a business around something they do; the bigger the business gets, the less they get to do what they got into business for in the first place.

Rehearsal is editing in pre-production

Last week Seth Godin wrote that rehearsing is for cowards. My first thought when I saw that headline was, “Seth Godin just called me a coward!”  If you’ve read my The importance of rehearsal, you know what I mean.

Like most of Godin’s writing, though, you have to take this one in the spirit in which it is written – deliberately extreme headline to catch your attention and then a very specific context in which it applies. In this case, his definition of rehearsal is very narrow and, to me, is really a definition of memorization.

At the end of the article he says that “A well-rehearsed performance will go without a hitch.” As if that is a bad thing. If you are trying to create your art live, then obviously it is bad. But not all art is created live and unfiltered, unedited.

Some art is created in post-production, when the book / album / film is edited into it’s final form.

And some art is created in pre-production, during rehearsal as things are tried and discarded, tried and changed, or new things added.

Rehearsal is simply editing in pre-production.

So you want to be a doctor? Really?

Standardization of medicine as a result of the desire for predictable outcomes. Unbelievable differences between US practice of medicine and doctors in other parts of the world.

Doctors as cogs in the machine as the “art” of medicine is systematically removed from the practice of medicine, despite the fact that those in the need of the most critical medical care require a doctor who grasps the art, not just the science. (Think “House, MD”).

What does it mean to be a “good” doctor? Who are you trying to please, who are you really serving? Should doctors be embarrassed about how much money they make? should they not make so much money? How much is too much?

Why would anyone want to be a doctor under these conditions?

These were all thoughts left rattling around in my mind after reading Atul Gawande’s book “Better”. I’m still not sure what to think.