In a paper about health services reform, Dr. Sholom Glouberman and Dr. Brenda Zimmerman address the differences between complicated and complex systems. To illustrate the differences, they “present a detailed account of complex adaptive systems using health care examples to indicate the explanatory power of the approach.”
They begin by illustrating an example of the distinction between simple, complicated, and complex problems (table above):
- Simple problems are ones like baking a cake from a mix. Success comes from following the recipe.
- Complicated problems are ones like sending a rocket to the moon. Sometimes we can break them down into a series of simple problems. But this is not always the case. Success often takes multiple people, multiple teams, and specialized expertise. Unanticipated difficulties are frequent. Timing and coordination become serious concerns.
- Complex problems are ones like raising a child. Once you learn how to send a rocket to the moon, you can repeat the process with other rockets and perfect it. One rocket is like another rocket. But not so with raising a child, the professors point out. Each child is unique and we must understand her as an individual. Although raising one child may provide experience, it does not guarantee success with the next child. Expertise is valuable but not sufficient. The next child may require an entirely different approach from the previous one. Which points to another feature of complex problems — their outcomes remain highly uncertain. Yet we all know that it is possible to raise a child well even as the process is complex.
It’s a valuable distinction and Glouberman and Zimmerman say we can approach all three kinds of problems with a certain degree of optimism, providing we understand which problem we are looking to solve. In the paper, they say healthcare experts often:
[…] implicitly describe complex problems as complicated ones and hence employ solutions that are wedded to rational planning approaches. These often lead to inappropriate solutions because they neglect many aspects of complexity. We are reminded of the old joke about the drunk who is stumbling around near a lamppost. He is asked what he is doing and says that he is looking for his car keys.
“Oh, where do you think you lost them?”
“Down the block near my car,” he says.
“So why are you looking for them here?”
“Because the light is better.”
They suggest this is something we should think about:
The sophistication of our models, theories and language for complicated problems can be as seductive as the lamplight. They provide better “light” and clarity and yet can lead to investigations that are ill-equipped to address complex adaptive systems.
Glouberman and Zimmerman provide a diagnostic lens through which we can view the type of problem we are trying to solve. They apply this lens to the future of the Canadian health care system, taking into account its inter-dependencies — without a clear understanding, we shift the problem from one sector to another without solving it, they say.
Determining the nature and perceived scale of a problem is a useful approach to begin addressing the tensions in a system and delivering an appropriate response.