Are You Solving the Right Problem, or Just Making a Broken System Faster?
Niklas Modig tells the story of Alison and Sarah, two women navigating the Swedish healthcare system in drastically different ways. Picture this: You wake up, go about your morning routine, and then, bam. You feel a lump in your breast. Your heart pounds. Your mind races. You need answers. Now.
That was Alison’s reality. Like anyone would, she went to her doctor. And then, she waited. And waited. And waited some more.
Why? Not because her doctor lacked skill. Not because the equipment was outdated. But because the system was designed for efficiency, the wrong kind (from a patients point of view).
The process felt like a bureaucratic relay race:
Each department ran like clockwork, specialists hit their quotas, machines were fully booked, administrators processed referrals on time. By all internal measures, the system was "efficient." Yet Alison still waited 42 days for a diagnosis.
Now, imagine Sarah. Same country. Same healthcare system. But one key difference: her hospital operates a One-Stop Breast Clinic.
She walks in. A cross-functional team of doctors, radiologists, and nurses assesses her case together, in real-time.
Two hours later, she walks out with a diagnosis.
Not 42 days. Two hours. 500 times faster!
What changed? The system wasn’t focused on keeping people busy. It was designed for flow.
Are We Solving the Right Problem?
It’s tempting to measure efficiency by how much we utilize people and machines. Hospitals track bed occupancy. Businesses monitor staff hours. Software teams count the number of tasks completed.
It feels logical, a fully booked doctor must be a productive doctor, right?
But what if the real question isn’t "How busy are our people?" but rather:
Optimizing the Wrong Thing: The Agile Coach in the Mammogram Unit
Now, imagine this: Instead of getting help redesigning the system for flow, the hospital hires an Agile Coach to improve… the mammogram unit.
So the coach gets to work:
Introduces daily standups, Implements Kanban boards, Optimizes WIP limits...
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And boom! The radiologists process scans faster than ever. Metrics improve, dashboards turn green, and management celebrates.
But does Alison get her diagnosis any sooner?
No.
Because the real bottleneck wasn’t in the mammogram unit. It was in the system-wide fragmentation that forced patients through endless handoffs and waiting periods.
How often do we see this in organizations? Optimizing a small piece of the puzzle while the overall experience remains broken?
Why Do We Keep Falling for the Efficiency Trap?
If improving flow leads to better results, why isn’t it the norm?
The answer often lies in what gets measured and rewarded. Here are, in my opinion, some common traps:
Siloed Budgets – Who Owns the Bigger Picture? When each department focuses only on its own costs and metrics, the system as a whole suffers. A hospital may cut expenses in one area while delays elsewhere increase overall costs. Faster patient recovery benefits society, people return to work, pay taxes, rely less on state support, but if that value doesn’t show up on the hospital’s balance sheet, why would they prioritize it? Can we really expect system-wide improvements when no one owns the bigger picture?
Short-Term Cost Cutting – At What Long-Term Cost? Big improvements need upfront investment. If budgets reward saving now over gains later, why take the risk?
The Wrong Metrics – Are We Measuring What Matters? Busy people, full schedules, machines running non-stop, it looks efficient. But if work isn’t flowing, is anything really getting done?
Perverse Incentives – Are We Rewarding the Wrong Things? If healthcare pays more for procedures than prevention, if businesses reward output over outcomes, how can we expect better results?
Resistance to Change – Why Stick to What’s Broken? Even when a better way exists, habits, structures, and incentives keep the status quo in place. How do we break free?
Zoom Out: Are You Fixing the System or Just Tweaking the Parts?
A well-designed system balances resource efficiency with flow efficiency, but too often, we get it backwards. We optimize for resource use first, squeezing every bit of capacity, and only then try to improve flow. But shouldn't it be the other way around?
Before celebrating an "efficiency improvement," ask yourself:
Because, as Alison and Sarah’s stories show, the difference between 42 days and 2 hours isn’t about working harder.
It’s about designing smarter.
Where do you see the efficiency trap in your organization? Drop a comment, I’d love to hear your thoughts.
Thank you for sharing Martin Ahlstr?m, very insightful ??