TOC Doctor aims to bring the benefits of Theory of Constraints to enable rapid improvement in medicine and wellness. Please join me for the journey. 

A Conversation About the Greats

A Conversation About the Greats

The Conversation

I recently listened to a conversation between Don Yaeger, who has written a lot about what makes the greats in sports, and Grant Williams, who has written a lot about being a great investor (paywall). Grant was interviewing Don about the similarities between what makes a great competitive athlete and team and comparing it to what makes a great investor. As they spoke, I heard lessons for making great addiction treatment.

Greats Hate to Lose

The first thing both of these men said that was true in both of their fields was that the greats hate to lose more than they love to win. Each loss is deeply felt and motivates them to do better. They said that those that were just good at what they do hate to lose as well, but they blame somebody. The great, hate failure, own it, and change because of it.

Does addiction treatment, as a field, hate failure? It doesn’t look that way to me. We tolerate losing people from treatment before they’re finished, and we make excuses like, “He wasn’t ready,” or “I guess he didn’t want it bad enough.” We have an opportunity to be great, by owning the failure. When we lose someone from treatment, we could ask why. Why did a perfectly sane person who wanted to get sober enough to come all this way here and pay us money leave early? And this time, the only wrong answer is that he wasn’t sane. Don’t let yourself fall into that trap. No excuses. Instead, find what we could have done better. Learn the lesson, and become greater.

Greats Move On

As much as these Greats in both sports and investing hated to lose, they immediately moved on to the next play or the next trade. Even though the last losing trade hurt deeply, they let it go, stayed in the moment and learned the lessons quickly to make the next trade or play.

Do we do that as a field? I don’t see it much. When we do look at our failings we do endless analyses of single cases, and then, rather than spend the time doing better with the patient, we endlessly try to get that original patient back to repair what we did wrong. That’s called doing/undoing and it’s a psychological defense against feeling failure. Remember, the greats feel the failure. They don’t want a defense. Do your best, learn the lesson, and move on to do better with the next patient.

Beyond Our Control

Grant brought up that in both sports and trading there’s a lot that’s beyond the individual’s control. He asked how sports greats handled that. Both men agreed that the greats only focus on those things that they can control. There are things out there that will change the outcome, “but did you do your best with what was in your control.” The greats just notice the outside and continue on with what they can do in the next play.

Do we do that in our field? I don’t think so. We complain about insurance companies. We complain about politicians and bureaucrats that have nothing to do with our treatment and aren’t even in the room. If we want to be great, we can stop focusing on those things that are beyond our control and instead focus here and now on what we can do.

Greats Handle Loss

But no matter how great you are at what you do, you’ll lose some. The best traders have bad days, bad weeks, bad months, and even bad years. So too do the best teams and best athletes. The lessons from our loses are more important than those from wins, so it’s important to understand how to handle loss. Don Yaeger said that the greats use losses as fuel. They use it to drive them to right a wrong. “A loss is not a failure until you make an excuse.”

Read that quote several times. "A loss is not a failure until you make an excuse." Write it down. Put it on the wall. It’s worth it.

Do we handle losses that way in addiction treatment? If we did, I’d never hear, “I guess he wasn’t ready” ever again. Oh, I can’t wait for that day.

The Best Advice

When asked the best advice he was ever given by a sports great, Don Yaeger said it was, “If you want to be better, improve your circle.” He said you are only going to get as good as the people you play with every day. If they aren’t challenging, you don’t grow.

Do we do that in our field? No, we insulate ourselves from it. We don’t look at internal medicine and compare our success to theirs. We don’t seek lessons from general surgery. We say how different we are, how unique. We talk about how much harder it is to do what we do.

General anesthesia used to kill 1 in 10,000 people who received it for a surgical procedure. I don't mean the procedure killed them; I mean in 1 in 10,000, "The surgery was a success but the patient died." In a 10 year period, the field of anesthesia looked at their problems, learned their lessons and moved on to improve so that now the death rate is 1 in 1 million. That’s an improvement of 100 times. If that was an investment it would be a 10,000% return in 10 years. 1 person dies today from anesthesia for every 100 that died before this 10 year process. What if we could do that with addiction treatment? We’ll never try if we keep on talking to the same people we have been talking to. We can enlarge and improve our circle.

The Bigger Picture

The biggest surprise that Yaeger found was that the greats all felt that they were in it for more than their personal success. They wanted to be in it for a mission. They believed in what they were doing and that it was more than they personally achieved. That’s how they get through the troughs whether it’s a bad year of losses or a losing season. What is it that brings a team back from a bad year. Yeager took a specific look at that for a few years and came away with something that came up more often. They have a sense of purpose, “that’s what allows them to weather the down times.”

This should be easy for us. We save lives. People die of addiction every day because of lack of treatment. We have an easy cause to believe in, but do we? Do we really, at core, believe? If we did, our goal would not just be to treat this patient or that patient, but rather to get rid of addiction as an entity entirely. Our goal should be to put ourselves out of business. Don’t worry, it won’t happen next Tuesday, and if it ever does, everyone else will want to employ the people who made it happen. But what I see in our field is not this greater idea, but rather just to muddle through treating addiction as if it’s just what is and will always be. We can get good at it, but do we want that? Or do we want to be great?

Dr Wetsman is currently make a documentary about addiction and how to end it as a problem in our life times. You can see the trailer here: https://www.youtube.com/watch?v=kssG2sxIKLY&t=7s

Government and Drugs

Government and Drugs

The Law of Striving

The Law of Striving