Bad Management Is Everywhere

A comparison between hospital and software management.

I've been watching The Pitt recently (spectacularly good, but so intense that binge-watching isn't an option—it’s too emotionally draining). The show is a real-time and accurate look into an Emergency Room over the course of a single shift, one hour per hour-long episode.

Watching it, I can't help but draw parallels between hospital management and many software shops. Profit reigns supreme in hospital management, which insists on tying the budget to customer-satisfaction scores but will allow no changes to improve the scores or their profit. (There's a 5-hour wait, but they won't provide the beds needed to reduce that wait.)

In one of the more dysfunctional companies I've worked at, the wacko CEO assembled the entire engineering team and announced that bonuses now were linked to the dubious measure of NPS. However, he set them up to fail. They had no control over what they were building, not even the UI, which was created by a separate UI team that was not tied to NPS. The teams also had no contact with the customers, so they had no idea how to improve. In fact, one of the engineers had just used the site extensively—she was a customer—and they ignored everything she had to say about how the UX could improve. In other words, the teams were held accountable for NPS but were not able or permitted to improve it.

In The Pitt, management spends no time in the ER, so they have no idea what problems the ER faces or what they're even doing. In fact, management refuses to help with those problems when the doctors tell them about them.

I don't know how many retros I've sat in where a critical improvement couldn't be made because "they'll never let us do that." "They" never came down to engineering, so they had no idea what the engineers were actually doing, and management did not trust the engineers enough to believe that the critical improvements were actually critical. They harp about budget but actively resist doing the things that would lower costs, saying that the budget won't allow it.

In fact, that wacky CEO I mentioned earlier would regularly appear in engineering, grab a random team (which was working closely with other teams), and demand that they immediately drop what they're doing and implement the "brilliant idea" that had just popped into his head. He had no idea how disruptive that was or how much that disruption cost the company. And the teams were still held responsible for the NPS on the thing they had been ordered to drop.

So, an engineering department is not an ER, but bad management is everywhere, and management acts in the same way, whatever the context. I guess they all went to the same sub-par business schools (and I include Harvard in that category). I dearly wish that this behavior wasn’t as commonplace as it is.