「華人戴明學院」是戴明哲學的學習共同體 ，致力於淵博型智識系統的研究、推廣和運用。 The purpose of this blog is to advance the ideas and ideals of W. Edwards Deming.
I came across a Chinese translation of Scientific Inference by Sir Harold Jeffreys. Unfortunately it is a second edition one .
I can browse it in Google Books, it is a third edition.
I don't know exactly the meaning of his ' epistemological probability".
And what is the main difference between his view of probability and Dr. Deming's.
Perhaps you might be of help to explain it to us.
That's a really difficult question. I will do what I can, but I had
better think first how to put it.
It happens that I spent years trying to solve to problems of "What is
Scientific Inference was one of the books that I found very inspiring.
But so were a lot of others.
Anyway, I will try to make some useful comments next week. But I must
find a way to reduce it to a few words.
Architectural Reflections: Studies in the Philosophy and Practice of Architecture [Paperback]Colin St.John Wilson (Author), Roger Stonehouse (Introduction)
The Taming of Chance 驯服偶然: 統計故事史
- [ 翻譯這個網頁 ]The Taming of Chance (1990); Scientific Revolutions (1990); Rewriting the Soul: Multiple Personality and the Sciences of Memory (1995); Mad Travellers: ...
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3 公开的业余人士 秘密的行政官僚
⊙ 劉 鋼
加拿大著名學者哈金（Ian Hacking）在當今英語世界中頗具盛名。他的《馴服偶然》（The Taming of Chance） 一書於1999年被「當代文庫」（Modern Library）叢書編委會評選為「本世紀英語世界最優秀的一百部非小說類作品」之一，在國際學術界影響很大。該書初版於1990年，1991年和 1992年有過重印。中央編譯出版社的「新世紀學術譯叢」於2000年出版了該書的漢譯本。哈金生於1936年，1956年畢業於英屬哥倫比亞大學數學與 物理學系；1958年又獲劍橋大學三一學院道德科學系學士學位；1962年獲劍橋大學文學碩士和哲學博士學位。自1982年起任加拿大多倫多大學哲學系和 科學史與科學技術哲學研究所教授。哈金長期從事統計思想史的研究，《馴服偶然》是他花費十年心血寫成的力作。
我國學術界對黃仁宇先生的作品和思想比較熟悉。十多年前，我參加了中國科學院組織翻譯李約瑟 （Joseph Needham）《中國科學技術史》的工作，在翻檢文獻時，見到他對黃先生關於「明代的漕運」這個專題的評價，李約瑟說黃先生的研究是一切圍著數目字轉。 而哈金的《馴服偶然》便是一部關於西方國家在現代化過程中如何利用數目字治理國家的書。黃先生曾頗有感慨地談到中國傳統的治國方式是「間架性的設計」，即 不由它「自身做主摸索而成，乃是由政治家鳥瞰的態度裁奪」。他認為這是「超時代的政治早熟」。正如李約瑟評價朱子時所說，在沒有產生一個牛頓式的宇宙觀之 前，先已產生了一個愛因斯坦式的宇宙觀。這種理念應用於社會政治方面，則出現這樣的情況，「一般政令上面冠冕堂皇，下面有名無實。結果則是中國的億萬軍 民，不能在數目字上管理」。在黃先生看來，中國最大的問題在於名與實之間沒有成功地得到鏈接，也就是說，中國不能用數目字治理國家。
於是，數目字治理便成為我們必須要補上的一課。實際上，「數目字治理」就是「現代化」的一種隱喻。我 們對於「現代化」的理解似乎總是一種時間的觀念。不論在英語還是漢語世界，均是如此。如中國學者何傳啟便提出人類社會的現代化過程分為四個時代、十六個階 段。然而，仔細探究一下，事情好像又不盡然。「現代化」一詞的英語是modernization。這個詞的詞根是拉丁語的modo，即「模態」的意思，所 謂「模態」就是要求人們這樣做，不要那樣做等等。轉義為「模型」、「型範」、「模子」的涵義，它規範著人們的行為方式。所以說「現代化」更像是一個「模型 化」的過程，因而更傾向於一個空間的觀念。那麼現代化的模型是個甚麼樣子的呢？我們說西方現代化基本上是按適應工業化大生產的「模型」安排的。中國有句成 語叫做「請君入甕」，「甕」就是個有形的「模子」，而「現代化」這個「模子」卻是無形的，但是每個人卻都要服從其「邊界條件」。
確定現代化的「邊界條件」是件很複雜的事情和漫長的過程，其中涉及到管理者對國家的各種構想。但是這些構想如果不付諸實施，就只能是空想。西方的現代 化始於何年何月已不可考。從「現代」（modern）一詞問世的1585年算起，大致不會出大的問題。這個年代基本也就是始於十四世紀歐洲的文藝復興年 代。後來經過宗教改革、地理大發現、工業革命等階段來到後現代。「後現代」一詞始見於1949年，也就是說，西方的現代化經過了三百多年的風風雨雨已經結 束了。西方社會目前處於一種「後現代狀況」。那麼在過去的三百多年間，這個使西方人「就範」的「模子」究竟是甚麼？其奧秘何在？這個話題便是哈金在《馴服 偶然》一書中所要講的故事。
哈 金本人將他的思想方法歸結為統計性的，因而他的世界圖景是統計學意義下的，即非決定論意義的。哈金 認為，他所持的這種思想方法或推理風格是晚近才有的，確切地說，「僅僅是1660年前後才問世的，而且直到十九世紀之前，統計的思想並沒有大的躍進」。那 麼，十九世紀後西方社會究竟發生了甚麼事情？在哈金看來，西方社會發生了一場「概率性革命」（probabilistic revolution）。凡是標以「革命」的事件，總是伴有劇烈的活動，而這場概率性革命的顯著特徵便是西方社會出現了印刷數目字的「雪崩」，最終導致數 千年決定論的觀念遭受「侵蝕」。決定論遭受侵蝕的結果便是社會逐漸「成為統計學意義下的了。一批類似自然定律但只與人有關的新形式的定律問世了」。
人們不禁要問，這類與人有關的新定律意義何在？新的定律「對人和世界的支配不 是更少了，而是控制更強 了……這便是偶然被馴服的原因所在」。這些根據概率論表述的新定律的內涵為「正常」和「偏離正常」的狀態，即我們熟知的那條高斯曲線。這便是令西方人就範 的那個無形的模子。人既然可以根據這兩種狀態來表示，那麼人性這個說不清楚的概念，便逐漸被「正常人」的概念取而代之，大家不再討論啟蒙時代所遺留下的人 性的問題了。這類有關社會和人的定律涉及偶然。偶然雖然在本質上是統計學意義的，卻是不容改變的，甚至是自調節的。同這些定律的集中趨勢保持一致者就是正 常人，而處於兩端者（離中趨勢）則是病理學意義的人。多數人都試圖使自己成為正常人，這反過來又影響到何為正常的問題。這類偏好在原子那裡找不到，人文科 學所顯示的是物理學中尚未發現的互動效應。
為了獲得一種精確的表現，統計研究伴隨著一個人的一生。它負責這個人的出生、洗禮、接種、中小學教育以及由此而來的成功、他的勤逸、離校，以及隨後而 來的高等教育和發展；而且一旦他長大成人之後，還負責他的體格以及從戎的能力。統計學伴隨他以後的人生道路，它記錄了這個人所選擇的職業，在甚麼地方成家 以及治家等；如果他從年輕時便為老年儲存了豐富的資源；他何時、在多大年齡結婚以及他娶了甚麼人為妻──不論事情是向好的方向發展還是向不好一邊滑落，統 計學都將照料著他。如果他經歷過沉船、遭受過物質的、道德的或精神的毀滅，統計學也照樣記錄。統計學只有當這個人死去之後才離開他──在他死後還要確認他 去世的準確年齡並記錄下他的死因。
這便是西方「卷宗社會」（dossier society）的基礎。在這樣的社會裡，利用人們日常生活所留下的各種數據，便可以掌握人的生活方式、習慣、下落、社會關係等等。因而，每個國家也都以 其自己的方式在統計學上表現出來。這類關於人的系統數據採集不僅影響到對一個社會的構想方式，也極其深遠地改變了我們的選擇，從擇業行為到思維方式。
馬克思主義經典作家曾一針見血地指出，問題不在於解釋世界，而在於改變世界。西方對社會的改變源於一 種理念，即通過點查和分類可以改善（控制）有異常行為的亞人口群體。然而，並非任何數目字都能起這個作用。許多定律般的規律都與異常現象相關：自殺、犯 罪、遊民、癲狂、賣淫、疾病等。由於十九世紀末雪崩般的統計數字，人的多種行為，尤其是異常行為，被列入官方的統計研究的範疇。通過研究發現，這些現象年 復一年似乎具有驚人的規律。有關社會的統計定律便是從這種關於人的異常行為的研究中發現的。其目的又是甚麼呢？根據平均值和離中趨勢的數據所形成的正常人 的思想，開始實施若干社會工程，以便「改造不合需求的社會階層」。正如優生學的創始人高爾頓（Francis Galton）於一百年前所說，概率定律的首要目的便是「在最具野性的混亂之中以寧靜和完全平淡的方式實施帝王式的統治」。
道理似乎人人都懂，關鍵還要看故事是否精彩。哈金講故事的方法也不同於以往的我們熟悉的科學哲學和科學史的舊套路。他用的是法國當代哲學家福柯 （Michel Foucault）的知識考古學的講法，以歷史和思想史的研究闡述其哲學思想。走進作者的世界，就好比進入一座博物館，每一章便是由各種數目字事實布置起 來的展廳。沿著博物館的長廊走下去，兩廂的展廳向我們展示了西方社會發生的那場持久的、全方位的概率性革命，使我們從一個側面看清了西方社會何以呈現出今 天這幅圖景的原因。
然而，「偶然」真被「馴服」了嗎？果真如此，自由意 志又當何如？這個問題哈金的回答非常巧妙。所謂「馴服」是統計學意義下的，作為個體，正如他所引用的馬拉梅（Stephane Mallarme）的詩：「孤注一擲絕不會破壞偶然性」。不論當骰子是在永恆的環境下擲出的──這可以使我們靜觀宇宙的星群；或者是在完全個人偏好的環境 下擲出的──這可以將我們個人的命運封緊，「偶然均湧入我們感官的每一條通道。」
R. A. Fisher, the life of a scientist by Joan Fis...
文章由 vmkljce 發表於
統計：從政治算術到一門科學（Statistics: from political arithmetic to a science）
「統計」是一個多義的名詞，而且，常常在面對質疑的意見時，被用來保證其可信度。我們有時使用它來談論資料，特別是指數值資料 － 例如，「93％的統計數值是編造的」。當在這些意義下使用時，統計（statistics）是個複數名詞：數據的每一小部分都是一個統計量（statistic）。當統計（statistics）作為單數名詞使用時，它所指涉的，是一門產生及分析這些數據的科學。這門科學有著悠久的歷史根源，但卻是在二十世紀初期才發展興盛起來。
統 計學與機率論息息相關，這可以解釋何以有些大學數學系將「機率與統計」合開為一門課程。不過，統計和機率卻是直到十八世紀初期，才共同發展成對 「不確定性」之數學研究的兩個緊密相關領域。事實上，它們是對相同的基本情況進行相反兩邊的考察。機率論探討吾人已知群體的未知樣本可以說些什麼？例如， 知道了投擲一對骰子一次可能得到的所有數值組合，那麼，下次投擲得到點數和為7的可能性是多少？統計學則是從調查一個小型的樣本，探究吾人對未知的群體可 以說些什麼？例如，知道在十六世紀一百位倫敦居民的壽命，我們是否可以推論出一般倫敦人（或是歐洲人，或是一般的人類）也可以活一樣久？
譬如說吧，第一本對機率論與統計學作廣泛充分討論的著作，是1713年由伯努利（Jacob Bernoulli）出版的《猜度術》(Ars Conjectandi)。 這本書分成四個部分，前三個部分討論排列、組合和流行的賭博遊戲之機率理論。在第四個部分，伯努利陳述了這些數學概念在例如政治、經濟或死亡率等領域有更 嚴肅及更有價值的應用。然則我們必須收集多少數據，才能合理地相信從數據所做出結論是正確的？（例如，為了要正確預測選舉的結果，我們需對多少公民進行民 意調查）？伯努利證明了：樣本愈大，結論正確的可能性愈高。而這，正是現在稱之為「大數法則」的著名定理。
樣本當然關係到數值資料的蒐 集。在歷史上，譬如羊群的大小，穀物的供應量，軍隊的人數等等紀錄，都有著相當古老的傳統。這些種類的資料所繪成的表 格，可以在古代文明中最早遺留下的史料裡尋得。他們被政治或軍事的領導人用來預測或防範可能發生的飢荒、戰爭、政治上的結盟或是國家其它的事務上。事實 上，統計這個字的來源就是state（國家）：它在十八世紀時被敲定，原指國家事務的科學性探究，但很快地重點被轉移至政府有興趣的政治或人口統計資料。
這種資料的收集，在人類有政府時就存在了。事實上，有些學者認為對這些資料的需求，就是數目本身被發明的原因之一。不過，一直到過去幾個世紀，人們才開始去思考如何去分析及瞭解這些數據的意義。1662年，格朗特 (John Graunt) 出版了《關於死亡清單的自然與政治觀察》(Natural and Political Observations Made upon the Bills of Mortality)。 這些死亡清單是倫敦每週及每年葬禮的紀錄，而早在16世紀中葉開始，就由政府來收集歸檔。格朗特將1604-1661年間的記錄整理成數值的表格，然後， 他敘述了所觀察到的模式：男嬰出生人數比女嬰多，女性活得比男性長，每年的死亡率（除非是有傳染病流行）大致上是一個常數等等。對一組同時出生的100位 倫敦人所組成的「典型」團體，他也估計了每十年的死亡人數。他這些被稱為倫敦壽命表（London Life Table）的表格化結論，代表了對平均壽命數值化估計的開始。
格朗特和伯提（William Petty, 1623-1687）一起建立了「政治算術」（Political Arithmetic）這門學問，也就是嘗試藉由如死亡清單這類資料的分析， 而獲得國家人口資訊。接著，很快就有其他人利用較好的數學方法來處理。例如，英國天文學家哈雷（哈雷彗星就是以他的名字命名）就編輯的一套1693年死亡 率表格，作為他研究保險年金的基礎。他因此成為精算科學（actuarial science）的創立者，這門學問針對平均壽命或其他人口統計趨勢，進行數學特性的研究。這類研究很快就成為保險業的科學基礎，依賴的是對各種不同保單 所冒風險的精算。
數據的可靠性對十八世紀歐洲的科學或商業而言，都是重要的議題。天文學被認為是決定經度的鑰匙，而經度測量的可靠性， 則是遠洋航海安全的關鍵。天文 學家為了決定行星軌道，也作了大量的觀測，但是，這些測量容易產生誤差，因此，如何從「混亂」的數據中，抽取出正確的結論，就變成是一件相當重要的事。同 時，保險公司開始收集各種數據，但是，那些數據都包含著偶然性所導致的變異，所以，吾人也必須按某種方式去區別什麼是真地會持續發生，而什麼又只是因為誤 差或機遇變異所導致的波動？針對這些問題，1733年，棣美弗（Abraham de Moivre）描述了我們現在所說的常態曲線（或正規曲線），作為二項分佈的近似。他使用這個想法（後來被高斯及拉普拉斯重新發現），去改善伯努利為了得 到精確結論所需觀測次數之估計。不過，棣美弗和他同時代的人並不總是能給出合適的答案，來回答對於真實世界的情況所提出的基本問題：觀測所得數據中的某些 特徵，到底在多少程度上，可以反應出吾人所研究的群體（或現象）的狀況？
法國數學家勒讓德（Adrien-Marie Legendre）發明了「最小平方法」，帶動了十九世紀統計理論的走向，而且從那時起，這個方法就是統計學家的標準工具。他利用這個方法，來從觀測所得 的數據中提取出可靠的資訊。不久後，高斯和拉普拉斯獨立地使用機率論來證明勒讓德的方法，也重新對它加以陳述使其更便於使用。於是，這個極有威力的工具便 逐漸在歐洲的科學家社群中傳播開來，這是因為它在進行大量數據依賴的研究，尤其有關天文學及測地學時，表現得十分有效。
在十九世紀，統計方法也隨著比利時人克威特列特（Lambert Quetelet）的開創性工作，而開始滲透到社會科學。1835年，克威特列特出版了一本書討論他所謂的「社會物理學」（social physics）的著作，在該書中，他嘗試運用機率的定律去 研究人類的特徵。他那新穎的「平均人」（the average man）概念，即在一個給定的情境下，對人類特徵的一個以數據為基礎的統計性構念，成為後來研究中吸引人的焦點。但是，它也被批評為過度延拓數學方法，將 其使用到多數人認為不可量化的人類行為（如道德）之上。事實上，在19世紀時，除了心理學之外，大部分的社會科學領域都對統計方法的滲入表示出相當抗拒的 態度。
統計由於在十九世紀獲得了許多進展，它便開始從機率論的陰影之中走出來，而成為數學的一個獨立學門。它的成年禮，是達爾文最年長 的一個表兄弟嘉爾頓 （Francis Galton）爵士在1860年代為遺傳學所做的研究。嘉爾頓是當時優生學運動的一份子，希望藉由選擇性的生育來改良人類的種族。因此，對於理解某些特徵 在母群體中是如何的分佈及如何（或者是否）遺傳，他有著很濃厚的興趣。為了彌補無法控制影響遺傳無數變因的缺點，嘉爾頓發展了兩個創新的概念：迴歸與相 關。在1890年代，高頓的洞察力被愛格伍斯（Francis Edgeworth）以及皮爾遜（Karl Person）和他的學生優爾（G. Udny Yule）所精練及延拓。優爾最後將嘉爾頓及皮爾遜的想法，發展成為迴歸分析中一個有效的方法論，其中，他使用了勒讓德最小平方法的一種微妙的變形。在二 十世紀，這個進展大大有利於生物及社會科學中廣泛使用的統計方法。
當統計理論成熟時，它的應用變得愈來愈明顯。二十世紀中許多大公司均 聘僱有統計學家。保險公司聘請精算師來估算在平均壽命及個人不可預期事件的考量 下，應收取的保險金額。其他公司則雇用統計學家來監控品質管制。因此，愈來愈多的統計理論上的進展，是藉由非學院人士之研究所取得。譬如，筆名「學生」 （Student）的哥薩（William S. Gosset），原在愛爾蘭金氏 (Guinness) 黑啤酒釀造廠工作。他最精彩的論文是處理抽樣方法，即從小樣本中提取出可信賴之資訊的特別方法。
不過，20世紀初期最重要的統計學家，非費雪（R. A. Fisher, 1890-1962）莫屬。由於同時具有理論上及實務上的洞察力，費雪得以將統計奠基在嚴密的數學理論上，使之成為一個強而有力的科學工具。他的《研究者的統計方法》（Statistical Methods For Research Workers），對很多世代的科學家而言，是一本劃時代的著作。還有，他的《實驗設計法》（The Design of Experiments)）則強調：為了獲得良好的數據，吾人應該要從為了提供那些數據所設計的實驗開始下手。費雪的研究將統計工具穩固地建立，而成為任何科學家所必備的工具。
今 日，我們看到統計技術應用到廣泛且大量的人類事務上。民意調查、品質控制方法，以及教育上的標準化測驗等等，都已經成為每天生活中司空見慣的部 分。尤其，電腦幫助統計學家處理大量數據的工作，也開始影響統計的理論與實務。因此，統計已不再被認為是數學的一個分支，即使它的理論基礎仍然充滿了數學 特性。統計史家史蒂格勒（Stephen Stigler）認為現代統計學既是一種邏輯也是一個方法論。在短短的幾個世紀中，對數據所提出的數學問題所播下的種子，已經成長茁壯為一個有自我目的及 標準的獨立學門，它對科學與社會兩方面，有著越來越重要的影響。
Porter, Theodore M. (1986). The Rise of Statistical Thinking 1820-1900. Princeton, NJ: Princeton University Press.
比爾‧柏林霍夫 / 弗南度‧辜維亞 (2008).《溫柔數學史》，台北：博雅書屋。
Social Security Administration Receives 16th Annual W. Edwards Deming Award
Graduate School USA Recognizes Excellence in Workforce Development and Training
WASHINGTON, May 24, 2011 /PRNewswire-USNewswire/ -- Graduate School USA presented its W. Edwards Deming Award to the Social Security Administration's (SSA) Office of Appellate Review on May 23, 2011. SSA's Office of Appellate Review won the award for an innovative program to quickly train new legal analysts who adjudicate disability claims.
With only 1100 judges, attorneys, and paralegals, SSA's Office of Appellate Review faced a dramatic increase in disability claims appeals following the 2009 economic downturn. The Office anticipated and met this challenge by creatively redesigning its training program for more than 400 new legal analysts. As a result, the Office was prepared with knowledgeable staff to promptly adjudicate a rising backlog of appeals and reduce the wait time for disability appeal decisions.
"The Deming Award recognizes leadership and excellence in training that achieves measurable results, and the Office of Appellate Review at the Social Security Administration is a worthy recipient," said Dr. Jerry Ice, CEO and President of Graduate School USA. "They understood the importance of training new analysts quickly but thoroughly to reach decisions on more than 100,000 disability appeals per year – appeals that are critical for many Americans."
The length of the training program was cut from eight to six weeks by using new approaches, and the result was more consistent decisions, the reversal of a decline in analyst output, and a drop in the backlog of pending disability claims. Most importantly, the program reduced the waiting time for Americans seeking disability benefits.
Graduate School USA presents the W. Edwards Deming award annually to a federal government organization or a civilian or uniformed branch of the military. The award highlights an impressive workforce development and training initiative that has measurably improved the organization’s performance and impacted its mission.
The award’s namesake is Dr. W. Edwards Deming, who taught at the Graduate School for 20 years and is considered the father of Total Quality Management. Described as “the third stage of the Industrial Revolution,” Deming’s work incorporated the idea that employees at all levels of private industry and government have a responsibility to cooperate to improve products and services.
To learn more about Graduate School USA’s W. Edwards Deming Training Award, visit graduateschool.edu/deming.
About Graduate School USA
Dedicated to providing relevant learning opportunities in public service, Graduate School USA has served the DC metro community since 1921. An independent, not-for-profit accredited educational institution, the School is dedicated to academic excellence and lifelong learning. Services include individual assessments, career-related courses, certificate and degree programs, continuing education, and distance learning. Graduate School USA has recently expanded its mission to reflect a greater emphasis on preparing the residents of the District of Columbia for long-term careers. More information can be found at graduateschool.edu.
May 19th, 2011
The Affordable Care Act of 2010 is expected to extend health coverage to some thirty-two million previously uninsured Americans. Two of the many challenges faced by both the private sector and the government are getting a handle on rapidly rising medical costs and providing care to the many new enrollees with chronic illnesses who are living in medically underserved areas. Health Affairs today released two Web First articles which describe programs tackling these issues.
Intermountain Healthcare: Trimming Costs Through Quality Improvement Efforts
Intermountain Healthcare is an integrated delivery system based in Utah and Idaho that provides more than half of all health care in that region. It has been identified as a low-cost, high-quality provider and has made demonstrated improvements in clinical quality that have lowered the cost of care delivery. By adopting the process management techniques of W. Edwards Deming and focusing on the processes of care delivery, Intermountain has learned to streamline its operations. While checklists, order sheets, and clinical flowcharts are routinely used, clinicians are comfortable modifying these guidelines when an individual patient’s particular needs warrant it, write Brent James and Lucy Savitz of the Institute for Health Care Delivery Research, Intermountain Healthcare, in Salt Lake City.
To make its system function smoothly, Intermountain identified 1,400 unique inpatient and outpatient work processes and discovered that 104 of these accounted for 95 percent of its care delivery. It then built evidence-based best-practice guidelines, outcomes tracking data systems, and management structure around high-priority clinical processes. For example, Intermountain estimates its labor induction protocol is able to reduce costs in its Utah centers by $50 million per year.
Project ECHO: Partnering Urban Academic Medical Centers And Rural Primary Care Clinicians
Project ECHO (Extension for Community Healthcare Outcomes) is an innovative new model of health care education and delivery in New Mexico. It uses state-of-the-art telehealth technology and care-based learning, enabling specialists at the University of New Mexico Health Sciences Center in Albuquerque to partner with primary care clinicians in underserved areas to deliver complex specialty care to patients with a host of chronic diseases. The program was originally developed for combating hepatitis C, report Sanjeev Arora of Project Echo and coauthors.
Primary care physicians in rural areas receive specific training to make the program a success. They travel to the University of New Mexico’s School of Medicine in Albuquerque for orientation and to learn the treatment protocol as well as the communications technology and cased-based presentation format for the weekly two-hour telemedicine clinics that lie ahead. The clinics, lead by the Albuquerque-based specialists, serve to review and discuss the rural patients’ needs with the primary care provider teams. The teams typically include physicians, nurses, and physician assistants and are organized into a disease-specific learning network.
Encouraged by its success dealing with hepatitis C, Project ECHO has expanded to address asthma, chronic pain, diabetes, and cardiovascular risk reduction, high-risk pregnancy, HIV/AIDS, pediatric obesity, rheumatology, substance abuse disorders, and mental illness. As of March 2011, 298 ECHO teams across New Mexico were delivering specialty care for these various conditions.
The New York Review of Books
by Newt Gingrich, by William R. Forstchen
Baen Books/distributed by Simon and Schuster, 382 pp., $24.00
To Renew America
by Newt Gingrich
Harper Audio, 260 pp., $17.00 two cassettes (abridged, approximately three hours)
Among the personalities and books and events that have “influenced” or “changed” or “left an indelible impression on” the thinking of the Hon. Newton Leroy Gingrich (R-Ga.), the current Speaker of the House of Representatives and the author of 1945 and To Renew America, are, by his own accounts, Abraham Lincoln, Thomas Jefferson, Franklin Roosevelt, Isaac Asimov, Alexis de Tocqueville, Tom Clancy, Allen Drury’s Advise and Consent, Robert Walpole, William Gladstone, Gordon Wood, Peter Drucker, Arnold Toynbee’s A Study of History, Napoleon Hill’s Think and Grow Rich, the “Two Cultures” lectures of C.P. Snow (the lesson here for the Speaker was that “if you’re capable of being glib and verbal, the odds are you have no idea what you’re talking about but it sounds good, whereas if you know a great deal of what you’re saying the odds are you can’t get on a talk show because nobody can understand you”), Adam Smith, Zen and the Art of Archery, “the great leader of Coca-Cola for many years, Woodruff,” an Omaha entrepreneur named Herman Cain (“who’s the head of Godfather Pizza, he’s an African-American who was born in Atlanta and his father was Woodruff’s chauffeur”), Ray Kroc’s Grinding It Out, and Johan Huizinga’s The Waning of the Middle Ages.
There were also: Daryl Conner’s Managing at the Speed of Change, Sam Walton’s Made in America, Stephen R. Covey’s The Seven Habits of Highly Effective People, The 1913 Girl Scout Handbook, Alcoholics Anonymous’s One Day at a Time, Gore Vidal’s Lincoln (“even though I’m not a great fan of Vidal”), the Sidney Pollack/Robert Redford motion picture Jeremiah Johnson (“a great film and a useful introduction to a real authentic American”), commercial overbuilding in the sunbelt (“I was first struck by this American passion for avoiding the lessons of history when I watched the Atlanta real estate boom of the early 1970s”), the science fiction writer Jerry Pournelle, the business consultant W. Edwards Deming (“Quality as Defined by Deming” is Pillar Five of Gingrich’s Five Pillars of American Civilization), and, famously, the Tofflers, Alvin and Heidi, “important commentators on the human condition” and “dear friends” as well.
Say you want to learn batik because a new craft shop has opened at the mall and the owner has told you she will sell some of your work. First, you check in at the “batik station” on the Internet, which gives you a list of recommendations. … You may get a list of recommended video or audio tapes that can be delivered to your door the next day by Federal Express. You may prefer a more personal learning system and seek an apprenticeship with the nearest batik master. … In less than twenty-four hours, you have launched yourself on a new profession.
Similarly, what begins in To Renew America as a rational if predictable discussion of “New Frontiers in Science, Space, and the Oceans” takes this sudden turn: “Why not aspire to build a real Jurassic Park? … Wouldn’t that be one of the most spectacular accomplishments of human history? What if we could bring back extinct species?” A few pages further into “New Frontiers in Science, Space, and the Oceans,” we are careering into “honeymoons in space” (“imagine weightlessness and its effects and you will understand some of the attractions”), a notion first floated in Window of Opportunity, in that instance as an illustration of how entrepreneurial enterprise could lead to job creation in one’s own district: “One reason I am convinced space travel will be a growth industry is because I represent the Atlanta airport, which provides 35,000 aviation-related jobs in the Atlanta area.”
The packaging of space honeymoons and recycled two-liter Coca-Cola bottles is the kind of specific that actually engages Mr. Gingrich: absent an idea that can be sold at Disney World, he has tended to lose interest. Asked, during an appearance this summer at the 92nd Street YMHA in New York, what he would have done early on about Bosnia, Mr. Gingrich essayed “creating a Balkan-wide development zone.” The somewhat anticlimactic ninth of his nine Principles of Self-Government for an Opportunity Society was this: “Finally, try, try again. Self-government is an arduous, demanding task on which the survival of freedom depends.” Many of the proposals in Window of Opportunity and To Renew America fritter out this way, dwindle into the perfunctory, as if the proposer’s attention had already hopped on. Mr. Gingrich, we are told by Dick Williams, manages his day in fifteen-minute increments, a lesson learned from Peter Drucker’s The Effective Executive. Mr. Gingrich, he himself tells us, believes in dedicating as many as possible of those fifteen-minute increments to reading, particularly to the reading of biography, which is seen to offer direct personal benefit: “I don’t care what you want to be. If you want to get rich, read the biographies of people who got rich. If you want to be a famous entertainer, read the biographies of people who got to be famous entertainers.”
Reading can provide not only this kind of intravenous inspiration but also “quotes,” what Forbes used to call “Thoughts on the Business of Life,” rhetorical backup to be plucked from the shoebox and deployed. “I was very struck this morning by something Bill Emerson used,” Mr. Gingrich noted at his swearing-in as Speaker. “It’s a fairly famous quote of Benjamin Franklin.” Mr. Gingrich tends to weigh whatever he does on this scale of strategic applicability and immediate usefulness: note that the fourth and fifth, or clinching, Reasons for Studying American History are “History is a resource to be learned from and used” and “There are techniques that can help you learn problem-solving from historic experience.”
A considerable amount of what Mr. Gingrich says has never borne extended study. There was the dispiriting view of the future as a kind of extended Delta hub, where “each news magazine would have a section devoted to the week’s news from space” and from which we would “flow out to the Hiltons and Marriotts of the solar system, and mankind will have permanently broken free of the planet.” There were the doubtful tales offered in evidence of the point at hand, the “personalization” (a key Gingrich concept) that did not quite add up. Mr. Gingrich learned that America was “in transition from one type of economy and lifestyle to another” from reading Peter Drucker’s The Age of Discontinuity and John Naisbett’s Megatrends, but the truth of this came home when he was “shocked to discover” that he could telephone his oldest daughter on her junior year abroad (the fact that his oldest daughter was born in 1963 would seem to place this discovery in 1982 or 1983) “by first dialing the 001 code for the international telephone computer, then the code for France, then the area code for the region near Paris, and finally the code for my daughter’s telephone.”
This was not a mind that could be productively engaged on its own terms. There was the casual relationship to accuracy, the spellings and names and ideas seized, in the irresistible momentum of Mr. Gingrich’s outlining, in mid-flight. In Window of Opportunity and in the lectures, Peter Drucker’s The Age of Discontinuity became The Age of Discontinuities. Garry Wills’s Inventing America became “Gary Will’s Discovering America,” Gordon Wood became Gordon Woods. To Renew America shows evidence of professional copy editing, but it also defines what it calls “situational ethics” and “deconstructionism” as interchangeable terms for “the belief that there are no general rules of behavior.” Alexis de Tocqueville is seen as a kind of visiting booster, whose privilege it was to “inform the world that ‘Democracy in America’ worked,” and also, even more peculiarly, as an exemplar of American culture: “From the Jamestown colony and the Pilgrims, through de Tocqueville’s Democracy in America, up to the Norman Rockwell paintings of the 1940s and 1950s, there was a clear sense of what it meant to be an American.”
There was and is still the flirtation with the millennial, the almost astral insistence on the significance of specific but intrinsically meaningless dates and numbers. The “discontinuity” in American history (Peter Drucker again) lasted, according to Mr. Gingrich, from exactly 1965 to exactly 1994: “And what’s been happening is that from 1965 to 1994, that America went off on the wrong track. Now that’s an important distinction.” “A year which ends in three zeroes is a rare thing indeed,” he declared in Window of Opportunity. “We’re starting the 104th Congress,” he said at his swearing-in last January. “I don’t know if you’ve ever thought about the concept: 208 years.”
This inclination toward the pointlessly specific (we have here a man who once estimated the odds on the survival of his second marriage at “53 to 47”) is coupled with a tic to inflate what is actually specific into a general principle, a big concept. The cherry blossoms in Washington, he advised his constituents in 1984, remind us that “there’s a rhythm and cycle to life. Winter goes and spring comes.” Forrest Gump became for Mr. Gingrich “a reaffirmation that the counterculture destroys human beings and basic values.” That Star Wars made more money than The Right Stuff instructs us that “we have allowed bureaucracies to dominate too many of our scientific adventures.” In the absence of anything specific to either seize or inflate, he tends to spin perilously out of syntactical orbit:
…I think if you will consider for a second—and this is part of why I wanted to pick up on the concept of “virtualness”—if you think about the notion that the great challenge of our lifetime is first to imagine a future that is worth spending our lives getting to, then because of the technologies and the capabilities we have today to get it up to sort of a virtual state, whether that’s done in terms of actual levels of sophistication or whether it’s just done in your mind, most studies of leadership argue that leaders actually are acting out past decisions, that part of the reason you get certainty in great leaders is that they have already thoroughly envisioned the achievement and now it’s just a matter of implementation. And so it’s very different. So in a sense, virtuality at the mental level is something I think you’d find in most leadership over historical periods.
The real substance of Mr. Gingrich’s political presence derives from his skill at massaging exhaustively researched voter preferences and prejudices into matters of lonely principle. The positions he takes are acutely tuned to the unexamined fears and resentments of large numbers of Americans, yet he stands, in his rhetoric, alone, opposed by “the system,” by “Washington,” by “the liberal elite,” by “the East Coast elite” (not by accident does a mention of Harvard in 1945 provoke the sympathetic President’s antipathy to “East Coast snobbery and intellectual hauteur”), or simply by an unspecified “they.” “I kind of live on the edge,” Mr. Gingrich told Dick Williams. “I push the system.” When, in a famous GOPAC memo, Mr. Gingrich advised Republican candidates to characterize Democrats with the words “decay,” “sick,” “pathetic,” “stagnation,” “corrupt,” “waste,” and “traitors,” and Republicans with the words “share,” “change,” “truth,” “moral,” “courage,” “family,” “peace,” and “duty,” each word had been tested and oiled in focus groups to function in what the memo called “Language, a Key Mechanism of Control.”
The 1994 Contract with America was packaged as, and to a defeating extent accepted even by its opponents as, a “bold agenda” (opponents said too bold, and argued only to split the difference), a “vision for America’s future” (opponents rushed to share the vision, and argued only the means), yet each of its ten items derived from and was later refined in focus groups run by Frank Luntz, who did the 1992 campaign polling first for Pat Buchanan and then for Ross Perot. “The Contract with America was specifically designed to appeal to the swing Perot voter who hates partisan politics,” Mr. Gingrich said this summer during his YMHA appearance. “The ten points basically selected themselves as deeply felt desires of the American people,” is his somewhat cryptic version of this process in To Renew America. “It can literally be said that the Contract with America grew out of our conversations with the American people and out of our basic conservative values.”
The preferences and attitudes discovered through opinion research tend to be, no matter who is paying for the research, fairly consistent. A majority of American voters are displeased with the current welfare system, believe that affirmative action has been carried too far, are opposed to crime and in favor of “opportunity.” They say this to researchers working for Republican candidates and they also say it to researchers working for Democratic candidates. Which was why, of course, anyone who knew how to count, anyone whose own researcher happened to be having identical conversations with the American people, was left, up against the Contract with America, with nowhere to stand. “Now what you’ve got in this city is a simple principle,” Mr. Gingrich told the Republican National Committee in January. “I am a genuine revolutionary; they are the genuine reactionaries. We are going to change their world; they will do anything to stop us. They will use any tool—there is no grotesquerie, no distortion, no dishonesty too great for them to come after us.” He described himself to Fred Barnes as “the leading revolutionary in the country. I’m trying to replace the welfare state and the counterculture and the old establishment with a system of opportunity and entrepreneurship and classic American civilization.”
What seems grandiose melts down, on the floor, to business as usual. “Replacing the welfare state” turned out to mean, with the passage in the House of the Personal Responsibility and Senior Citizens Fairness Acts, phasing out a $16 billion welfare program for the poor (Aid to Families with Dependent Children) in order to expand, by lifting the level of its earnings test, what was already a $335 billion welfare program for the middle class, Social Security. The unfairness (Frank Luntz has isolated “fairness” and “unfairness” as hot words) of applying any earnings test at all to Social Security benefits was an issue seized early by Mr. Gingrich, who illustrated it in Window of Opportunity with another doubtful tale, this one featuring “Warren, a retiree” who “wanted to do something to keep his mind and body busy and to contribute to the community and world he loves” but was forced to give up selling his contribution of choice, which happened to be scrimshaw, when the Social Security Administration threatened to reduce, or, in Mr. Gingrich’s telling, “cut off,” his benefits. “Politics,” Mr. Gingrich instructed Dan Balz and Charles R. Babcock of The Washington Post when they suggested that this preference for what the speaker calls “sixty-five percent issues” could be construed as pandering to public opinion, “is about public opinion and gathering public support. It’s like saying, isn’t it pandering for Wal-Mart to stock everything people want to buy.”
“I teach a course which is an outline of my thoughts at 51 years of age, based on everything I’ve experienced, which is, frankly, rather more than most tenured faculty,” Mr. Gingrich told The New York Times in January. “I’m not credentialed as a bureaucratic academic. I haven’t written 22 books that are meaningless.” What details we have about the formative experience of the current speaker, who was born Newton Leroy McPherson and took the surname of his mother’s second husband, describe a familiar postwar history, one not dissimilar from that of the current President, who was born William Jefferson Blythe and took the surname of his mother’s second husband. Each was the adored first-born son of a mother left largely, in the economic and social dislocations that transformed provincial America during and immediately after World War II, to her own devices. Each was farmed out to relatives while the mother earned a living. Each appears to have reached adolescence firm in the conviction that these were the make-or-break years, that the point of the exercise was to assert, win over, overcome.
The two relied on different means to this end, but the instinctive technique of each derived from the literature of personal improvement, effective self-presentation, salesmanship, five simple steps. Mr. Clinton, with his considerable personal magnetism, kept extensive lists of people he had met and, when the time arrived, on whom he could call. In the case of Mr. Gingrich, who after his mother remarried was repeatedly uprooted and moved from one army post to another, Kansas to France to Germany to Georgia, such social skills remained undeveloped, forcing him back on his reading, his self-education, his shoe-boxes. He recalled being given an article when he was young. “It was about Lincoln’s five defeats. I carried it in my wallet for years.” At sixteen, en route from Stuttgart to Fort Benning, he concluded “that there was no moral choice except to immerse myself in the process of learning how to lead and how to be effective.” His stepfather gave him a set of the Encyclopedia Americana, and he read it every night. At Baker High School near Fort Benning he yielded to the Southern pressure to play sports, but was sidelined by headaches. His Democratic opponent in 1994 referred to him as a “wuss,” and as “the guy who won the science project.”
“I think I was very lonely and very driven,” Mr. Gingrich told Dick Williams. “If you decide in your freshman year of high school that your job is to spend your lifetime trying to change the future of your people, you’re probably fairly weird.” The defense he adopted was the persona of “class brain” (his classmates voted him “Most Intellectual”), the one with the pens and slide rule in his shirt pocket, the one who could spark the debating society, tie for highest score in the county on the National Merit Scholarship test, make a strategic detour around his lack of aptitude for high-school cool by tutoring the school beauty queen and not-quite-secretly dating the geometry teacher. As a freshman at Emory he married the geometry teacher and co-founded the Emory Young Republican Club. As a graduate student at Tulane he organized a week-long protest against administration censorship of the college paper, discovered Alvin Toffler, and taught a non-credit class on The Year 2000.
He took for himself, in other words, the ritualized role of breaker of new ground, marcher to a different drummer, which happens to be the cast of mind in which speculative fiction finds its most tenacious hold. What if one or another event had not occurred, what if one or another historical figure had remained unborn, languished in obscurity, taken another turn: the contemplation of such questions has reliably occupied the different drummers of American secondary education. The impulse is anti-theological, which translates, for these readers, into thrilling iconoclasm: in Isaac Asimov’s Foundation trilogy, according to Mr. Gingrich, “the Catholic Church’s role in maintaining civilized knowledge through the Dark and Middle Ages is played by a secular group of intellectuals called ‘The Foundation.’ ” The tendency is to see history as random, accidental, the sum of its own events and personalities: Isaac Asimov, Mr. Gingrich notes, “did not believe in a mechanistic world. Instead, to Asimov, human beings always hold their fate in their own hands.”
It was this high-school reading of Isaac Asimov, Mr. Gingrich tells us in To Renew America, that first “focused my attention on the fate of civilizations. I came to realize that, while most people were immersed in day-to-day activities, daily behavior actually takes place within a much larger context of constantly changing global forces.” Mr. Gingrich is frequently and often deprecatingly described as a “futurist,” but even as he talks about those “constantly changing global forces,” about a transformation “so large and historic that it can be compared with only two other great eras of human history—the Agricultural Revolution and the Industrial Revolution,” his view of the future is a view of 1955, factory-loaded with Year 2000 extras. To Renew America asks us to “imagine a morning in just a decade or so”:
You wake up to a wall-size, high-definition television showing surf off Maui. (This is my favorite island—you can pick your own scene.) You walk or jog or do Stairmaster while catching up on the morning news and beginning to review your day’s schedule. Your home office is filled with communications devices, so you can ignore rush-hour traffic. … When you are sick, you sit in your diagnostic chair and communicate with the local health clinic. Sensors take your blood pressure, analyze a blood sample, or do throat cultures. The results are quickly relayed to health aides, who make recommendations and prescribe medicine. … If you need a specialist, a databank at your fingertips gives you a wide range of choices based on cost, reputation, and outcome patterns. You can choose knowledgeably which risk you want to take and what price you want to pay.
The “diagnostic chair,” or “personalized health chair,” which could also be programmed to “monitor your diet over time and change recipes to minimize boredom while achieving the desired nutritional effect,” appeared first in Window of Opportunity, which outlined a future in which we or our descendants would also use computer technology to correct golf swings, provide tax and IRA advice, and provide data on “literally thousands of vacation, recreation, and education opportunities,” for example the Ocmulgee Indian Mounds Park in Macon, Georgia, with its “splendid natural walk area, a beautiful collection of ancient Indian ceremonial mounds, and fine museum on the history of the area from 900 AD to the present.” For any among us whose view of the future might have been somewhat more forbidding or interesting (no Maui, no Macon, the IRAs all gone bust), Mr. Gingrich would recommend first the reading of science fiction, since “a generation that learns its magic from Tom Swift or Jules Verne has a much more optimistic outlook than one that is constantly being told that the planet is dying and that everything humanity is doing is wrong.”
If wishes were horses, as they said in the generation that learned its magic from Tom Swift or Jules Verne. We hear in this the drone of the small-town autodidact, the garrulous bore in the courthouse square: to know that large numbers of Americans are concerned about getting adequate medical care is one thing; to give them the willies by talking about their “health chairs” is altogether another. There is about these dismal reductions something disarming and poignant, a solitary neediness, a dogged determination to shine in public that leads Mr. Gingrich to reveal to us, again and again, what his own interests dictate that we should not see. He concludes To Renew America with a “personalization” of his concern for voter concerns, an account of how he and his second wife, Marianne, spent the Christmas before he became Speaker in Leetonia. Ohio, “a wonderful small town that is like a scene from a Norman Rockwell Saturday Evening Post cover.”
For much of this account Mr. Gingrich remains well within the secured territory of the Taking Back Our Streets and American Dream Restoration Acts. He expresses concern for Marianne’s eighty-year-old mother, who “worked and saved all her life” but now worries about “the reports that Medicare will go bankrupt by 2002.” He worries that his eight-year-old nephew, Sean, “cannot walk around Youngstown the way I once wandered the streets of Harrisburg.” He wonders how Marianne’s sister and her husband will manage putting their boys, Jon and Mark, through college.
Then, midway through this tuned and calculated Christmas reverie, Mr. Gingrich drops, abruptly and inexplicably, through the ice, off message: “At heart,” he dismayingly confides, “I am still a happy four-year-old who gets up every morning hoping to find a cookie that friends or relatives may have left for me somewhere.” This cookie is worrisome: Was it forgotten? Hidden? Why would they hide it? Where are they? Are they asleep, out, absentee friends, deadbeat relatives? The cookie was the treat and leaving is the trick? What we get from these problematic detours and revelations, from the cookies and the health chairs and the high-resolution views of Maui, from the Ten Steps and the Five Pillars and the thirty gigabytes to an improved golf swing, is a shadow of something unexplained, a scent of failure, which remains one reason why, in a country made even more uncomfortable by losers than Mr. Gingrich claims to be, personal popularity among large numbers of voters may continue to elude him.
The Difficult Transition from For-Profit to Nonprofit Boards
|Published:||May 12, 2011|
In the new book Joining a Nonprofit Board: What You Need to Know, authors F. Warren McFarlan and Marc J. Epstein observe that service on a nonprofit board can be a frustrating experience for executives grounded in a for-profit world. Read our excerpt.
Editor's note: For those of who have attended meetings of both nonprofit and for-profit boards, the differences between the two organizations couldn't be clearer. Nonprofit boards meetings tend to be longer, less tightly organized, and more sporadically attended by the board members themselves. Why this happens is one of the many subjects discussed in the new book Joining a Nonprofit Board: What You Need to Know, by authors Marc J. Epstein of Rice University and F. Warren McFarlan of Harvard Business School. In this excerpt from the introduction, Rice and McFarland highlight the major similarities and differences between the different types of boards and what newcomers to nonprofit governance can expect.
Comparing Nonprofits and For-Profits
There are a number of important similarities and differences between the operations and challenges of nonprofits and for-profits of which a new nonprofit board member must be cognizant. Some of the more important items are discussed in this section.
There are a number of similarities between for-profits and non-profits which make people with for-profit experience particularly helpful as board members. The key similarities include:
- Both organizations can grow, transform, merge, or die. Success is not guaranteed for either type of organization, but requires sustained work.
- In both cases, cash is king. This for-profit focus is critical for a nonprofit board.
- In both settings, good management and leadership really matter. Delivery of service, motivating and inspiring staff, and conceiving of new directions for growth are all vitally important.
- Planning, budgeting, and measurement systems in are vital in both settings.
- Both types of organizations face the challenges of integrating subject matter specialists into a generalist framework.
- Both organizations add value to society. They just do it in different ways.
In short, there is much overlap between the skills needed and perspectives provided by leaders in the two types of organizations. This is a key reason why social enterprise courses have taken root in business schools and why, appropriately socialized, those with for-profit backgrounds can contribute so much to the nonprofit world.
Repeatedly we have seen new trustees and ineffective boards try to wag the mission dog with the financial tail.
Having noted all of this, the blunt question in your mind is: why do I need to read a book on nonprofit management? Isn't it just a subset of the for-profit world, with little difference in the tasks and perspectives of managers and board members? Cannot the tools, practices, and viewpoints developed throughout a career of successful for-profit work be transferred to this new realm of nonprofit? The authors answer this question with an emphatic no! Although, as noted, many aspects are the same, in important areas there are deep differences. Failure to understand these differences can cause the new board member to stumble badly and perhaps irretrievably damage her credibility and effectiveness in a nonprofit organization.
At its core the nonprofit is fundamentally different than the for-profit. At the center of the nonprofit is its social mission. Understanding the mission, helping the organization to fulfill it, and adapting it to a changing world is the very core of nonprofit governance and management. It is for this reason this book starts with a detailed discussion of mission and how it grows. Right behind this are the two major intertwined strategic themes that the nonprofit trustee must deal with.
The first theme is fulfilling the mission and whether we are doing it in a fiscally responsible fashion. Chapter Two deals with the complex multifaceted issue of mission definition and evaluation of its appropriateness. Chapter Three shows, in a series of examples, how organizations can go about measuring their performance against mission. For the new trustee, understanding these issues is the place to begin her trusteeship. The second theme is financial solvency. Chapter Four deal's with the board's fiduciary responsibility and financial sustainability. Our life experience drives us to put this behind "performance measurement against mission." Repeatedly we have seen new trustees and ineffective boards try to wag the mission dog with the financial tail. It just doesn't work that way. Without mission and its accountability we have nothing.
Achieving financial sustainability is very different for the nonprofit than the for-profit in that the nonprofit cannot easily access the public equity markets but instead has philanthropy as a potential additional source of funds. Chapter Five deals with the role of philanthropy and the trustee's role in it. This may be summarized by giving often and generously and when not giving helping others to give (hence the phrase, "give, get, or get off.")
Finally, the execution of the work of the board is deeply different from that of boards in the for-profit world because of the tasks of mission performance measurement and different capital markets. As Chapter Six describes in detail, nonprofit boards are often larger, have more committees, and have a very different trustee life cycle. Further, as Chapter Seven describes, the heart of the governance process is a volunteer nonexecutive chairman and volunteer board, leading a staff of paid professionals. The dynamics of this are complex and profoundly different than the process in the for-profit world. Chapter Eight returns directly to you, the new trustee, addressing what you should consider before deciding to join a board and what you can do to make your trusteeship personally beneficial to you and the organization.
Reprinted by permission of the publisher, John Wiley & Sons, Inc., from Joining a Nonprofit Board: What You Need to Know by F. Warren McFarlan and Marc J. Epstein. Copyright (c) 2011 by John Wiley & Sons, Inc. All rights reserved.
Building a Better Board
|Published:||May 11, 2011|
While corporate board members take their jobs more seriously than ever, they are not necessarily as helpful or effective as they could be, says HBS senior lecturer Stephen Kaufman. He recently sat down with HBS Working Knowledge to discuss what he considers to be the biggest practical issues facing boards today. Key concepts include:
- Board directors may not give an honest assessment of the company because they fear reprisal from the CEO or the other board members.
- In accurately evaluating a CEO's performance, board members must get feedback from other employees at the company, who possess insight into day-to-day operations that the directors do not.
When Stephen Kaufman took the helm at Arrow Electronics in 1982, it was de rigueur for CEOs to sit on the boards of several other companies in addition to running their own. Back then, serving as a board member didn't require much of a time commitment, and governance was a matter of trust.
"So who's going to tell Bill that we really like his ideas, but that his management style pisses people off? It can feel very threatening and frightening for board members to think, 'If I pick on Bill, will he pick on me?' "
By the time he retired in 2002, the board-serving landscape had changed considerably. These days, serving on a few boards can comprise almost a full-time job. While quarterly board meetings used to last maybe half a day, including a catch-up-with-the-buddies lunch, meetings now span a day and a half and they happen up to six times a year. While reviewing relevant materials used to mean flipping through the annual report on the plane ride to the annual meeting, it now means spending several hours poring over hundreds of pages of company documents and SEC filings looking for problems, unreasonable risks, or even signs of fraud.
"I see much more time being spent—more meetings, longer meetings, more meaningful meetings, and more pre-meeting materials to be studied," says Kaufman, a senior lecturer at Harvard Business School who sat on one outside public board during his tenure at Arrow and has since served on four other public boards and five private boards.
"There has been a tremendous shift to the better over the past 15 years," he says. "The improvement started on its own without any major external events in the late 1990s, accelerated dramatically with the accounting scandals of the Enron era plus the passage of Sarbanes-Oxley, and then continued to change under the pressure of shareholder activism. There's a lot more attention paid to non-fun stuff now, much of it being compliance mechanics that add very little to the competitive position or underlying value of the enterprise."
But while board members are now taking their jobs more seriously, their input is not necessarily as helpful or effective as it could be, Kaufman says. He recently sat down with HBS Working Knowledge to discuss what he considers to be the biggest practical issues facing boards today: how to get and give honest assessments without eroding collegiality and trust; how to evaluate the CEO using factors that go beyond financial results; how to diagnose the corporate culture; and how to contribute meaningfully to strategy development.
Making it safe to be critical
Chief among the responsibilities of a corporate board member is to develop and share an honest assessment of the company's performance, including the performance of the CEO. The problem is that directors sometimes worry that delivering honest criticism will hurt the group's collegiality or, worse, result in reprisal—namely, getting kicked off the board and losing a gig that often pays six figures annually, plus stock options or shares.
"At $150,000 a year—a typical compensation package for a Fortune 1000 company director—it's real money," Kaufman says. "So who's going to tell Bill that we really like his ideas, but that his management style pisses people off? It can feel very risky for board members to think, 'If I pick on Bill, will he pick on me?'"
"The goal of the performance review is not just to fill out a report card, but also to help make a good CEO a great CEO."
Corporations can mitigate this issue in a couple of ways, he says. For starters, they can hire an outside recruiter to enlist new board members, so that the board includes more than just acquaintances of the CEO or other current directors. This can serve to cut down on the clubby board atmosphere. Outside recruitment has grown more common in recent years, in part because of improved governance and in part because the usual playing field of director candidates has begun to thin out organically.
"As business in general globalized and became more competitive in the '90s, as the world became more difficult, CEOs got busier and joined fewer boards," Kaufman says. "That was one of the things that led boards to look further afield for directors. They ran out of active CEOs they knew from other companies who were willing to serve."
Boards also can make it feel safer for directors to give honest assessments by hiring an outsider to interview each board member individually and aggregate the information for both the board and the CEO. "That person puts together a report that says, 'Here's what your fellow board members said you could do to be more effective as a board member or as a CEO," Kaufman says.
More comprehensive assessment metrics
Historically, a board member's assessment of a CEO's performance simply involved asking a couple of questions. One, did we make the numbers? Two, is the stock price doing OK? "It was a 10-minute conversation, and that was that," Kaufman says.
These days, the assessment is usually much more wide-spread, taking into account both quantitative and qualitative metrics other than just recent financial results, such as customer satisfaction, employee engagement, and even the CEO's leadership style and character. But even these broader assessments can lack accuracy and credibility. Too often, the board members' appraisal is based largely on how the chief executive acts at periodic board meetings and occasional one-on-one meetings, rather than on how he or she handles day-to-day activities with customers, managers, and front-line employees during the rest of the year. The CEO who seems measured, thoughtful, and open for three or four hours in the board room six times a year may actually be inciting a mass exodus among unhappy customers, disgruntled subordinates, or disengaged employees.
"I can give great PowerPoint presentations, but that doesn't tell people whether I'm Attila the Hun or a New Age Leader, or if I create a culture of fear, a culture that accepts and respects dissent, or a culture of energy and enthusiasm," Kaufman says. "A board sees the CEO at highly structured—and possibly well-rehearsed—board meetings, at a few dinners and perhaps at an annual golf outing. That doesn't tell the board whether the CEO is a listener or a lecturer, an autocrat or a democrat, or a fan of yes-men. But those are the things you need to need to know if you want to give a CEO meaningful counsel. The goal of the performance discussion is not just to fill out a report card to justify the compensation decision, but also to help a good CEO become a great CEO."
When he was at Arrow, Kaufman instituted a policy where the independent directors based their assessments of him on direct, private conversations with company executives at multiple levels of management. (He detailed the process in a 2008 Harvard Business Review article, "Evaluating the CEO.") He suggests that this, or a similar process should become industry standard.
"When companies get into trouble it doesn't usually happen overnight; it happens over the course of two or three years. Figuring that out before the numbers go bad is the greatest art of a board member."
Incorporating input from across the company also helps directors to gauge corporate culture in a way they can't from the ivory tower of the boardroom. It's important to ask questions such as, Are employees engaged? Are they enthusiastic? Are all the really smart engineers quitting in frustration? Are the best salespeople looking for new jobs? Are the high-potential, next-generation senior managers energized and growing? The answers can help the board realize whether a company with great financial results today may have terrible results in six months, six quarters, or six years—unless there's an intervention.
Kaufman recommends that board members periodically request that the company conduct anonymous surveys about employee engagement and the company culture, and then ask that the data be shared in raw form, "not the chewed and digested and spun form." He also suggests urging board members to make occasional visits to company facilities and sit in on town hall meetings.
"When companies get into trouble it doesn't usually happen overnight; it happens over the course of two or three years," Kaufman says. "Figuring that out before the numbers go bad is the greatest art of a board member."
Boards of directors also are expected to help steer strategy development, not only in small venture-backed and private companies, but in large public companies, too. Kaufman says this is increasingly difficult to do well.
"To develop good, actionable strategies you need to understand customer needs, customer behavior, and the technology behind the product or service," he says. "How is the technology developed? What changes or threats are on the horizon? What value does your product create for your customer? If you don't know these things then it's hard to develop strategy because you really don't know what's needed or what's possible. It's relatively rare that many directors really understand the physical technology or how the business operates at the street level. Therefore, it's really hard for a board to be deeply and constructively involved in developing the strategy."
Other than company insiders, those most likely to understand a company's technology and customers are its competitors and—in the case of B2B enterprises—its customers. But senior executives from such companies are generally discouraged from serving because of potential conflicts of interest.
Meanwhile, companies are under increased pressure to diversify their boards in order to include more minorities, women, and social activists. While shaking up the historical old boys' board networks may be good for balance, Kaufman observes that it can make strategy development and performance oversight that much harder. "The push for diversity creates a tension for us. We need to ensure that we recruit directors who understand the underlying technology, customer needs and patterns, and operational characteristics of the business, so they can contribute effectively to the critical strategy and investment decisions that come before the board," Kaufman says. "One lesson from the recent global financial crisis was that some financial institution boards had few directors who really understood the workings of—and risks inherent in—the sophisticated and complex derivative instruments being created and sold."
About the author
Carmen Nobel is senior editor of HBS Working Knowledge.
A spoonful of medicine...
Should economics be more like medicine? I don't mean that economists should be more like doctors – I've met a few doctors – but that economists should learn from the relationship that medical practice has with medical evidence.
Medicine, like economics, deals with complex systems that are still not well understood; like economics, it has its share of quacks; but unlike economics, medicine has swallowed many of its ethical qualms about running controlled experiments in difficult circumstances.
Randomised controlled trials are now catching on in economics, especially development economics. (Such a trial would involve, for instance, approving loans to a randomly chosen subset of loan applicants.) Two new books, Poor Economics and More Than Good Intentions, each by leading practitioners of randomised trials, explain the consequent discoveries.
隨機對照實驗如今在經濟學領域很流行，特別是發展經濟學。 （例如，這種實驗可能涉及批准向隨機選取的貸款申請者發放貸款。）兩本新書——《貧窮 (可能誤譯) 經濟學》(Poor Economics)和More Than Good Intentions的作者都是隨機實驗的領先實踐者，書中對隨後的發現進行了解釋。
Clearly such trials have their limits, but I'ma big fan of the approach. However, it would be a great shame if economists learned nothing more from doctors than to use randomisation.
One lesson that has emerged all too slowly from medical practice is the need for trial registries, in which researchers give notice that a clinical trial is about to begin, noting exactly what they will do.
Trial registries sound like a pernickety piece of bureaucracy. In fact, they could hardly be more important. When analysing any statistical finding, researchers must allow that sometimes remarkable patterns emerge by chance. Imagine that there are 20 researchers, each investigating whether mint humbugs cure cancer. Purely by happenstance, we'd expect one of the researchers to find evidence that they do. She'll approach a medical journal and get her fascinating results published. The other 19 researchers may not bother at all – or, realising that their research is destined to be published in The Journal of Uninteresting Results, they will drag their heels.
實驗註冊聽上去像一種麻煩的官僚作風。實際上，它們極為重要。在分析數據發現時，研究人員必須承認，不尋常的模式有時會意外出現。假設有20名研究人員，各自都在調查薄荷硬糖能否治愈癌症。純粹出於意外，我們預計有一位研究人員發現了肯定的證據。她會接洽醫學雜誌，將吸引人的結果公之於眾。另外19名研究人員可能會毫不介意，或者，如果意識到他們的研究注定將在《無趣結果雜誌》(The Journal of Uninteresting Results)上發表，他們會不合作。
In short, published research is systematically biased in favour of striking results that may be coincidence. The trial registry matters because later researchers into the anti-carcinogenic properties of humbugs can take all the non-results into account.
Dean Karlan, a Yale economist, co-author of More Than Good Intentions, and founder of Innovations for Poverty Action, which co-ordinates and evaluates development projects in poor countries, argues that trial registries are harder to design in social science than in medicine . Researchers cannot control a project as tightly as clinicians can – they may find that the project they are evaluating is changed halfway through.
耶魯大學(Yale)經濟學家迪恩•卡蘭(Dean Karlan)辯稱，社會科學領域的實驗註冊比醫學領域更難設計。研究人員對項目的控制無法像臨床醫師那樣嚴格，他們可能會發現，他們正在評測的項目在中途就發生了變化。卡蘭是More Than Good Intentions一書的聯席作者，Innovations for Poverty Action的創始人——該公司與貧窮國家合作，對這些國家的開發項目進行評估。
High-quality empirical research is not just a matter of using tools such as randomised trials and trial registries – it's about the entire research culture. A simple example: if academic careers are in thrall to the number of articles published in the top journals, and if the top journals are not interested in publishing boring-sounding replications of earlier research, then these replications will not be attempted. Yet replication is a foundation of experimental science.
Professor Jonathan Shepherd, a clinician at Cardiff University, points out that the culture of evidence permeates medicine. Doctors are trained in university hospitals; their professors are themselves practising doctors, and their research agenda is driven by their needs as medical practitioners.
卡迪夫大學(Cardiff University)臨床教授喬納森•謝潑德(Jonathan Shepherd)指出，證據文化滲透整個醫學界。醫生在醫學院接受培訓；他們的教授本身就是行醫的醫生，他們的研究日程受到他們作為行醫者需要的推動。
Meanwhile their pupils, thoroughly indoctrinated as to the value of medical evidence, read about new research in the British Medical Journal every week. In short, in medicine, academic evidence and everyday practice are intertwined. No doubt this symbiotic relationship is less than perfect in the real world; nevertheless it is something economists would do well to emulate.
同時，他們的學生被徹底灌輸了醫學證據的價值，他們每週都會閱讀《英國醫學雜誌》(British Medical Journal)上發表新的研究。簡而言之，在醫學領域，學術證據和日常實踐交織在一起。毫無疑問，這種共生關係在真實世界里遠沒有那麼完美；然而，經濟學家最好能效仿一下。
Tim Harford's latest book is 'Dear Undercover Economist' (Little, Brown)
本文作者的新書是《親愛的臥底經濟學家》(Dear Undercover Economist)，Little, Brown出版社出版
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