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Philosopher James Wilk claims he can transform any workplace with his "minimalist interventions". Big firms pay him handsomely. But is he for real?
Patrick Borgen took the post of chief surgeon at Maimonides Medical Centre in Brooklyn, New York, in January 2009.His brief: to cut surgical errors. It was a big task: the 30-day mortality ratio -- the ratio of observed to expected deaths -- had rocketed to 1.43 in 2008, earning Maimonides “high outlier” status. (The ideal score is 1 or less.) Borgen knew that the culture of the surgical department had to change, but he didn’t know how.
Hospital president Pamela Brier suggested that Borgen meet James Wilk, a 54-yearold Oxford philosophy don who teaches a course on Wittgenstein at St Edmund’s Hall when not running Interchange Associates, a five-person think tank.
“I didn’t see how someone with no intimate knowledge of an amazingly complicated hospital could accomplish this,” says Borgen. “He had no background in healthcare politics or finance.” Borgen met Wilk that March in a quiet room at the New York Academy of Medicine, where he began to outline his problem, the same way he had done many times before for management consultants. So he was surprised when Wilk said he didn’t even want to hear about the problem. Instead, Wilk asked Borgen to describe, in fine detail, how his department would look if he were to come back from a holiday. Two four-hour sessions later, the two men had their solution. One element was geographical: over the years, surgeons had landed wherever there was office space. Borgen identified a hallway in the hospital and started by clustering six heart surgeons together on the same corridor.
Wilk also proposed developing a protocol for handovers between anaesthetists supervising an operation, and those on duty in the ward. Borgen taped a list of back-up surgeons, with their pager numbers and specialities, to the refrigerator in the common room. “It sounds simple,” admits Borgen, “but it immediately established a team culture.”
Within a year, Borgen reckons, surgical errors at Maimonides reduced tenfold. The 30-day mortality rate dropped to 1.08, cancelling the “high outlier” tag. Borgen estimates that 20 to 30 lives have been saved as a direct result. In January 2010, the hospital received the Distinguished Hospital Award for the first time from Health Grades, a healthcare-ratings company, putting it in the top five per cent of hospitals in the US.
For the advice, Wilk charged a flat quarterly fee of £150,000. “I couldn’t have imagined that the return on the investment would be as much as it was,” says Borgen. Wilk’s solutions were examples of what he calls “minimalist interventions”. He says he has executed 750 of these interventions since the late 80s, mostly for major companies including Shell and Prudential Financial, plus the NHS and others whose identities are confidential. Wilk says that he can solve any problem, no matter how large or longstanding, with an easy, custom-designed and entirely personal consultation. He claims he can do this from scratch, usually in four hours, no matter what the sector. He has spent 35 years researching the methodology behind interventions, he explains, completing postgraduate work across philosophy, psychology, social science and cybernetics.
“Everybody’s had experiences where they’ve had some big success in their life. They look back and realise it was down to one or two small things that they did,” Wilk says at his Georgian townhouse in Bath. “If they’d known to do them early on -- one phone call, a dinner with one person -- it would have saved a lot of effort. My point is, you can find those things in advance.”
Short and balding, Wilk looks like Kevin Spacey with a more intense manner.When we meet in his working library in Bath -- his name arose during research for the wired 100 -- he peppers his speech with anecdotes (including how he was thrown out of an NGO’s head office for suggesting that the Middle East could be fixed with a one-liner). When Wilk describes his research and what it will take to convince the academic establishment, he compares himself to Galileo -- the original misunderstood genius. “It’s something one should never say about oneself,” he says. “But I believe it’s true.”
Four of the largest books in Wilk’s library -- where he keeps his kaleidoscope collection -- comprise his thesis. His friends call it “the slab”. Its title is Principium Metamorpholigica. Metamorphology, from metamorphosis, is, according to Wilk, a “nascent discipline” concerned with the science of change. So far, Wilk is its only practitioner. His thesis is highly technical, drawing on the work of cyberneticians such as Gregory Bateson and DJ Stewart, who supervised the doctoral work. Its central argument: that change is instant and easy, no matter how large the system.
Besides his thesis, Wilk has published little academic material -- he claims there are no peers who could review his work. “He’s either a genius or a fraud,” says Ned Hall, a professor of philosophy at Harvard University. Others are more openly dubious: “Most things that seem too good to be true turn out to be exactly that,” says Kamal Munir, a lecturer in strategy at Cambridge University, who read a paper specially prepared by Wilk for this article. “James Wilk’s radical-change theory is one of those things. In one stroke, Wilk has tried to do away with more than a century of research on organisational change. Most management and organisational theorists would simply shake their head at these claims.”
Wilk knows his claims are extraordinary.On our first meeting, over lunch in an Italian restaurant in Mayfair, he outlined his research, leaned over the table and said: “If you were not highly sceptical, I’d have grave doubts about your critical faculties.”
Although Wilk is happy to discuss the theory, he is loth to detail his dealings with clients. He says he has never spoken to the press. Those who will talk about their work with Wilk offer opaque praise. Jo Ivey Boufford, a client of Wilk and president of the New York Academy of Medicine, calls it “a really innovative, revolutionary approach” -- but she refuses to go into details. “There is one thing,” she says, “but I can’t talk about it. It’s pretty amazing. I couldn’t reveal it to a particular audience -- it wouldn’t work.” However, a few are more open. Dave Franzetta worked with Wilk in 1996, when Franzetta was vice-chairman and chief financial officer of Prudential Real Estate and Relocation Services, a US private insurer with $693 billion in current assets. Franzetta says he saved Prudential $15 million during the company’s sale to an investment bank. How? Wilk had him deliver “a little message” to his counterpart at the bank as they played golf in Florida. A deal that should have cost $25.5 million went ahead for only $11 million.
Franzetta is one of the few executives willing to talk about his work with Wilk -- but he has a vested interest. When he retired in 2004, he became president of Interchange Associates Inc; he now owns the licensing rights to its methods. He’s frustrated by Wilk’s reticence, saying: “We need clients to stand up and give testimony to the efficacy of our methods.” Wilk doesn’t see the need. He believes that his research should remain confidential. “I am not prepared to use clients as cannon-fodder. As for the unconvinced among the professoriat or anywhere else -- good luck to them. I think it’s inevitable that my ideas will take root, because the results speak for themselves. Galileo had a harder job.”
This article was originally published by WIRED UK
