What’s Your Poison?


Imagine you’ve been out to a restaurant for a meal and when you get home, you experience agonising stomach cramps, blurred vision and other symptoms too horrible to describe here.

When you’re well enough to leave the house, you return to the restaurant to complain. The manager makes some enquiries in the kitchen, then informs you that the cook had added a few drops of poison to your food.

The cook meant well though; after all, he’d been adding poison to customers’ meals for a while and no one had died.

Anyway, the manager is really sorry that you’ve had a bad experience. He admits he’s heard that poison can sometimes cause adverse effects, so as a gesture of goodwill he suggests the following options to prevent future poisonings:

1. The cook could be more careful about the way he mixes the poison into the food. Maybe it’s the way the cook is pouring it that’s the problem, rather than the actual poison.

2. He could use less poison. (Perhaps a nice little bottle like the one below, instead of that big evil one). Or maybe water it down a bit. This way, the effects wouldn’t be as bad.

poison_bottle small

3. Alternatively, he could try using different types of poison. Maybe it’s just that particular type of poison which is the problem.

In any case, the manager absolutely refuses to stop using poison – He laments, “What alternative is there to the use of poison?”


Well that’s all just a bit silly isn’t it? Who’d knowingly put poison in food, thinking it would improve it? Furthermore, who’d honestly believe those ‘options’ for preventing future poisonings would actually make a difference?

Number 1 assumes it’s a people problem and that applying the same poison in a slightly different manner will achieve different results. (Definition of madness, anyone?)

Number 2 is what John Seddon calls, “Doing less of the wrong thing”, or what Russ Ackoff says is, “Doing the wrong thing righter”.

Number 3 is just a desperate denial that the poison could ever possibly be the problem. “Hey folks, it must have been the wrong type of poison!” Of course. Let’s go and poison people with slightly different strains instead! Genius.

And as for the manager’s pitiful concerns about what they’d be left with if they removed the poison from the recipe… well I’ll tell you. No poison in your food.

Can you see where this is going yet? You might have guessed there’s a ‘hidden’ meaning to this story. Let’s recap. It’s…

  • Something known to cause adverse, yet unintended effects when introduced into the equation.
  • Something that some managers cling to because they can’t see what the alternatives might be.
  • Something whose entirely predictable consequences are reacted to as in the ‘options’ above, rather than by addressing the root cause – the poison itself.

Still unsure?

Then go back and read the post again, but replace the word poison with numerical targets.

About InspGuilfoyle

I am a serving Police Inspector and systems thinker. I am passionate about doing the right thing in policing. I dislike numerical targets and unnecessary bureaucracy.
This entry was posted in Systems thinking and tagged , , , . Bookmark the permalink.

4 Responses to What’s Your Poison?

  1. Uncivilised Servant says:

    Are you arguing against any form of numerical target? It’s reasonable to know the direction of travel for public services so data needs to be gathered and published, and an idea given of what is acceptable performance. So, targets.

  2. Yes, there’s a risk that when effort is directed by management to be focused on a particular area similar behaviours can ensue, particularly when managerial pressure is exerted to demonstrate success. But targets exacerbate the risk.

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