What do you think?
Rate this book
Upstream: The Quest to Solve Problems Before They Happen
So often in life, we get stuck in a cycle of response. We put out fires. We deal with emergencies. We stay downstream, handling one problem after another, but we never make our way upstream to fix the systems that caused the problems ... [This book] probes the psychological forces that push us downstream--including 'problem blindness,' which can leave us oblivious to serious problems in our midst. And Heath introduces us to the thinkers who have overcome these obstacles and scored ... victories by switching to an upstream mindset.
315 pages, Kindle Edition
First published March 3, 2020
About the author
Dan Heath
44 books383 followersDan Heath is a Senior Fellow at Duke University's CASE center.
Dan has an M.B.A. from Harvard Business School, and a B.A. from the Plan II Honors Program from the University of Texas at Austin.
He co-wrote a book titled Switch: How to Change Things When Change Is Hard with his brother Chip Heath.
Dan has an M.B.A. from Harvard Business School, and a B.A. from the Plan II Honors Program from the University of Texas at Austin.
He co-wrote a book titled Switch: How to Change Things When Change Is Hard with his brother Chip Heath.
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 30 of 672 reviews
April 29, 2020
Upstream is an excellent book that talks about the value of thinking in systems and finding/fixing the root cause of problems.
There are many things to like about Upstream.
First and foremost is the topic itself, which is something that not many people think about. The majority of us are reactive, caught up in day to day minutiae. A few of us have the will, fire and thought process to think bigger to figure out that there is a problem and actually make an attempt at solving it. You can see this in our personal and corporate lives where the mantra of the day is to put out the current fire and not really make an attempt to understand the reasons behind it. If nothing else, this book will make some of us think differently and in itself, that is a good start.
Secondly, Dan Heath has obviously done a lot of research on this topic and has come up with the gotchas and a primitive heuristic to help us start this journey. This book is divided into three portions - what prevents us from upstream thinking, how do we start this journey / what do we need to watch out far and it ends with some upstream stories. These topics are all presented in an easy to read manner with plenty of examples and anecdotes that are quite entertaining & informative.
But, there is one issue I have with this book (that many books in this genre have). It does not get into down and dirty details of execution. While the heuristic helps, it is quite high level. For example - how do we know that we are succeeding? This book gives us some ideas but is it in a form that we can take and implement? Not really. In that sense, Upstream is more like a book that helps light the fire in us to start a trip but does not really tell us how to do so. This is not a deal breaker though. I still liked the book and it is inspiring and thought provoking.
So, overall, I would recommend this book. It is well worth a read.
There are many things to like about Upstream.
First and foremost is the topic itself, which is something that not many people think about. The majority of us are reactive, caught up in day to day minutiae. A few of us have the will, fire and thought process to think bigger to figure out that there is a problem and actually make an attempt at solving it. You can see this in our personal and corporate lives where the mantra of the day is to put out the current fire and not really make an attempt to understand the reasons behind it. If nothing else, this book will make some of us think differently and in itself, that is a good start.
Secondly, Dan Heath has obviously done a lot of research on this topic and has come up with the gotchas and a primitive heuristic to help us start this journey. This book is divided into three portions - what prevents us from upstream thinking, how do we start this journey / what do we need to watch out far and it ends with some upstream stories. These topics are all presented in an easy to read manner with plenty of examples and anecdotes that are quite entertaining & informative.
But, there is one issue I have with this book (that many books in this genre have). It does not get into down and dirty details of execution. While the heuristic helps, it is quite high level. For example - how do we know that we are succeeding? This book gives us some ideas but is it in a form that we can take and implement? Not really. In that sense, Upstream is more like a book that helps light the fire in us to start a trip but does not really tell us how to do so. This is not a deal breaker though. I still liked the book and it is inspiring and thought provoking.
So, overall, I would recommend this book. It is well worth a read.
Read
January 6, 2020I received a galley—this book hasn't hit the shelves yet. It's a fascinating discussion about the importance of looking "upstream" to solve problems—i.e., figure out solutions to avoid making them in the first place.
April 18, 2020
I devour Heath books like candy, this one was good, but not as good as Decisive and Power of Moments.
There's the old saying that 'a stitch in time saves nine.' That's what this book's about. We all recognize the value of being proactive, but the issues with solving problems upstreams are manifold: It's exceedingly hard to prove causation. It's easy to know how many people a hospital saves, but less so how many lives a public health campaign saves. We all know which one is better funded. We all have a hunch where the return-on-investment is significantly higher. It's much more efficient in the long-term to try to keep people in high school, than to repair the damage that may have resulted in later.
One of my favourite quotes from the book: "Every system is perfectly designed to get the results it gets." Reading the book and getting this sentence hammered in again and again was almost worth it in itself.
All systems need to be be tuned to work a little further upstream. By default, they tend to drift downstream. This even though it's hard to quantify sometimes. That all work has to be measured can be troublesome, because it favours initiatives that are easy to measure on short time-scales (downstream) over those that may work much more cost-effectively on a longer time-scale (upstream).
We are so bad at this it's tragic. Even through C19 most countries reacted slowly. Unfortunately, this has given me less, rather than more, hope for minimizing climate change.
There's the old saying that 'a stitch in time saves nine.' That's what this book's about. We all recognize the value of being proactive, but the issues with solving problems upstreams are manifold: It's exceedingly hard to prove causation. It's easy to know how many people a hospital saves, but less so how many lives a public health campaign saves. We all know which one is better funded. We all have a hunch where the return-on-investment is significantly higher. It's much more efficient in the long-term to try to keep people in high school, than to repair the damage that may have resulted in later.
One of my favourite quotes from the book: "Every system is perfectly designed to get the results it gets." Reading the book and getting this sentence hammered in again and again was almost worth it in itself.
All systems need to be be tuned to work a little further upstream. By default, they tend to drift downstream. This even though it's hard to quantify sometimes. That all work has to be measured can be troublesome, because it favours initiatives that are easy to measure on short time-scales (downstream) over those that may work much more cost-effectively on a longer time-scale (upstream).
We are so bad at this it's tragic. Even through C19 most countries reacted slowly. Unfortunately, this has given me less, rather than more, hope for minimizing climate change.
October 18, 2020
"The question is not: Who suffers most from the problem? The question is: Who's best positioned to fix it, and will they step up?"
If you've ever uttered the phrase, "That's not my job!", then this is not the book for you. Stop reading this review now and find another book to read while there's still time to remain helpless. You won't like this one.
Early in the book, my most favorite quote sums up the best problem-solving advice I've ever read: "I'd like each of you to tell the story of this situation as though you're the only one in the world responsible for where we are... When Forrest prodded them to explain the situation as if they were the ones responsible, they uncovered their power. They went from feeling like victims of the problem to feeling like co-owners of the situation... When you look at the world that way, you start to see angles of influence."
I found Dan Heath's premise for writing this book fascinating: we avoid upstream problem-solving, in part, because there's not as much renown in it. He calls this concept "tunneling" (being so overwhelmed that you can't deal with a problem unless it finally gets out of control) and he explains that tunneling "is not only self-perpetuating, it can even be emotionally rewarding. There is a kind of glory that comes from stopping a big screw-up at the last second." In short, it's easy to recognize when someone steps in or steps up to save the day. It's more difficult to recognize who saved the day if the day never comes down to needing saving. Other similar problems within this same vein are "problem blindness" (not being able to see that there is a problem) and "lack of ownership" (it's not my job to solve that problem).
If you've read any of Chip and Dan Heath's other books, this one is on par with the other ones. What I really like about their efforts, and what you'll also see in this one, is that they take a broad concept (in this case, solving problems in general) and they use really specific scenarios and real-life happenings to drill down to the details in such a way that the reader can take the lessons and apply them immediately to their own problems and scenarios in their own lives in real-time and expect to see real results.
This title promises a lot and then it delivers all that it promises. Great book!
If you've ever uttered the phrase, "That's not my job!", then this is not the book for you. Stop reading this review now and find another book to read while there's still time to remain helpless. You won't like this one.
Early in the book, my most favorite quote sums up the best problem-solving advice I've ever read: "I'd like each of you to tell the story of this situation as though you're the only one in the world responsible for where we are... When Forrest prodded them to explain the situation as if they were the ones responsible, they uncovered their power. They went from feeling like victims of the problem to feeling like co-owners of the situation... When you look at the world that way, you start to see angles of influence."
I found Dan Heath's premise for writing this book fascinating: we avoid upstream problem-solving, in part, because there's not as much renown in it. He calls this concept "tunneling" (being so overwhelmed that you can't deal with a problem unless it finally gets out of control) and he explains that tunneling "is not only self-perpetuating, it can even be emotionally rewarding. There is a kind of glory that comes from stopping a big screw-up at the last second." In short, it's easy to recognize when someone steps in or steps up to save the day. It's more difficult to recognize who saved the day if the day never comes down to needing saving. Other similar problems within this same vein are "problem blindness" (not being able to see that there is a problem) and "lack of ownership" (it's not my job to solve that problem).
If you've read any of Chip and Dan Heath's other books, this one is on par with the other ones. What I really like about their efforts, and what you'll also see in this one, is that they take a broad concept (in this case, solving problems in general) and they use really specific scenarios and real-life happenings to drill down to the details in such a way that the reader can take the lessons and apply them immediately to their own problems and scenarios in their own lives in real-time and expect to see real results.
This title promises a lot and then it delivers all that it promises. Great book!
June 6, 2021
This is highly readable and covers super-important ground. My disappointment with it was that over and over the examples used were pretty far downstream, which is weird for a book called "Upstream." This is even illustrated by the life preserver on the cover.
As far as drowning prevention goes, throwing a lifesaver is just one small step upstream from jumping into the water to rescue someone. Maybe the author felt that the concept of Upstream is so alien to our culture that he could only hope to get people to understand a tiny step away from where we are now.
Still, it would have been good to move further upstream over the course of the book. For example, for preventing the awful consequences of Type 2 diabetes, yes it's good to check blood sugars, but wouldn't it be even better to look at what's different in countries that don't have so much Type 2 diabetes in the first place, and then do more of that?
As far as drowning prevention goes, throwing a lifesaver is just one small step upstream from jumping into the water to rescue someone. Maybe the author felt that the concept of Upstream is so alien to our culture that he could only hope to get people to understand a tiny step away from where we are now.
Still, it would have been good to move further upstream over the course of the book. For example, for preventing the awful consequences of Type 2 diabetes, yes it's good to check blood sugars, but wouldn't it be even better to look at what's different in countries that don't have so much Type 2 diabetes in the first place, and then do more of that?
March 29, 2020
The whole idea of "upstream thinking" is about pro-active solving of root causes of the problems. Instead of reactive dealing with their visible symptoms.
The idea ain't new (of course) - DN's (author's) goal is to convince the reader why the changing of the
mindset (from downstream to upstream) is beneficial & why (at the same time) we're leaning towards downstream thinking.
The book itself is quite well written, there are plenty of examples, which do "touch" several other topics - e.g. systems thinking, antifragility, locals success criteria.
It wasn't a bad read, but all the topics covered in the book felt more like re-iteration & summarizing of something that has been (in a very similar form) stated somewhere else. I couldn't find any re-igniting spark that would help me classify, systematize or even refresh the concepts.
3.2-3.5 stars
The idea ain't new (of course) - DN's (author's) goal is to convince the reader why the changing of the
mindset (from downstream to upstream) is beneficial & why (at the same time) we're leaning towards downstream thinking.
The book itself is quite well written, there are plenty of examples, which do "touch" several other topics - e.g. systems thinking, antifragility, locals success criteria.
It wasn't a bad read, but all the topics covered in the book felt more like re-iteration & summarizing of something that has been (in a very similar form) stated somewhere else. I couldn't find any re-igniting spark that would help me classify, systematize or even refresh the concepts.
3.2-3.5 stars
April 21, 2020
يدور الكتاب حول التخطيط الاستباقي، أو ما يمكن تسميته بالوقائي. لكنّ الكاتب يشير إلى أنّه اختار الاسم الدرامي "عكس التيار"ليوحي بعملية مستمرة في الحفاظ على التوازن والسلامة عند المنبع، بدلاً من البقاء تحت ضغط حلول المشاكل الطارئة عند المصبّ.
كُتُب الأخوين "هيث"، وهذا الكتاب لـ"دان" منفردًا، تطرح في العادة فكرةً محدّدة؛ تُطرح نظريًا، ومن ثمّ يتم نقاش تطبيقها وما يلزم لتنفيذها، أو ما قد يعيق ذلك. يُطرح ذلك في نطاق مؤسساتي وفردي.
فكرة هذا الكتاب هي التفكير الاستباقي. وتدور أسئلة الكتاب حول أهميته، ولمَ هو عكس التيار؟ وما الذي يجعله صعبًا أو بعيدًا عن السلوك الروتيني للمؤسسات والأفراد؟ ما هي متطلبات مثل هذا التفكير والتحديات التي يمكن أن تواجهه؟ وما هي آفاقه وأين يمكن أن يصطدم؟
يجيب كلّ فصلٍ في الكتاب عن سؤالٍ من تلك الأسئلة، أو جزئية من سؤال، بلغة سلسلة وأسلوب ممتع؛ يدمج القصة الموجزة مع الأفكار العلمية والنتائج البحثية. كما أن استطرادات الكاتب غالباً ما تكون محددة وذات ارتباط واضح، وهذا مما يُحسب لمثل هذه الكتب التي تعتمد هذا الأسلوب في الكتابة.
وللمقارنة، فإن كتب "هيث" الأخرى أكثر أهمية وغنىً معرفيًا من هذا الكتاب.
كُتُب الأخوين "هيث"، وهذا الكتاب لـ"دان" منفردًا، تطرح في العادة فكرةً محدّدة؛ تُطرح نظريًا، ومن ثمّ يتم نقاش تطبيقها وما يلزم لتنفيذها، أو ما قد يعيق ذلك. يُطرح ذلك في نطاق مؤسساتي وفردي.
فكرة هذا الكتاب هي التفكير الاستباقي. وتدور أسئلة الكتاب حول أهميته، ولمَ هو عكس التيار؟ وما الذي يجعله صعبًا أو بعيدًا عن السلوك الروتيني للمؤسسات والأفراد؟ ما هي متطلبات مثل هذا التفكير والتحديات التي يمكن أن تواجهه؟ وما هي آفاقه وأين يمكن أن يصطدم؟
يجيب كلّ فصلٍ في الكتاب عن سؤالٍ من تلك الأسئلة، أو جزئية من سؤال، بلغة سلسلة وأسلوب ممتع؛ يدمج القصة الموجزة مع الأفكار العلمية والنتائج البحثية. كما أن استطرادات الكاتب غالباً ما تكون محددة وذات ارتباط واضح، وهذا مما يُحسب لمثل هذه الكتب التي تعتمد هذا الأسلوب في الكتابة.
وللمقارنة، فإن كتب "هيث" الأخرى أكثر أهمية وغنىً معرفيًا من هذا الكتاب.
March 7, 2020
This is one of the most important topics--and not just for leaders. Thinking ahead and preventing problems is one of the most powerful things we can do. So I was super excited about this book. And it was good. But it wasn't quite as good as I hoped. The stories of upstream change are marvelous. The writing skill is top quality. So it's really fun to read. But the principles stayed at the broad/general level and didn't get tactical enough that I felt like someone could go home and start solving things upstream because of this book.
So it's a brilliant book for opening your eyes to the need to go upstream. But it's only a beginner's guide on how to actually do it. (To be fair, I don't know of another book that does give tactical guidance for upstream solving.) Still very much worth reading though.
So it's a brilliant book for opening your eyes to the need to go upstream. But it's only a beginner's guide on how to actually do it. (To be fair, I don't know of another book that does give tactical guidance for upstream solving.) Still very much worth reading though.
October 13, 2021
The main message of this book is hard to argue with: we spend a lot more energy solving problems than preventing them, and we should do the opposite. Overall, there were a lot of interesting and non-obvious points here about how to do this, but the book got pretty repetitive by the end.
Random thoughts that resonated:
- People talk about how the US spends a lot more on healthcare than other countries, but this isn't true if you factor in "social care" (upstream healthcare spending). We spend about the same as some developed countries, but they allocate it more on preventative stuff we wouldn't even consider healthcare, and have better outcomes.
- There is a whole section on "tunneling": when reacting to problems takes up all of your focus and removes time and brain space to think about bigger-picture ways to prevent problems. This happens to me all the time in life and at work. In general, this is a huge issue for researchers, who often end up focusing on e.g. conference deadlines and lose track of the bigger problem to be solved. Heath's proposal for how to avoid this is to use 'slack': time specifically dedicated to upstream thinking. I am trying to be more intentional about this by explicitly scheduling it.
- It's really important to use metrics to measure progress AND not to over-rely on metrics, which are always flawed and can result in worse outcomes than you started with. One interesting idea is that you should always consider "paired" metrics: if you have a quantity-based target, you should simultaneously be tracking a quality-based target, and vice versa.
- It's better to start off with a rough solution to a problem, have a system in place to track how you're doing, and use that to keep making the solution better, than it is to have a really good initial idea for a solution and no way to measure progress. ("We don’t succeed by foreseeing the future accurately. We succeed by ensuring that we’ll have the feedback we need to navigate.")
- We tend to hold upstream work to a higher standard than downstream work in a way that's not productive. For example, we don't care about costs when we're saving someone's life, but it's often not enough for preventative measures to result in fewer deaths -- they're expected to also save costs down the line.
- That said, a really hard open problem is figuring out who will pay for upstream work; often, the people who bear the cost for preventative work do not benefit from it.
Random thoughts that resonated:
- People talk about how the US spends a lot more on healthcare than other countries, but this isn't true if you factor in "social care" (upstream healthcare spending). We spend about the same as some developed countries, but they allocate it more on preventative stuff we wouldn't even consider healthcare, and have better outcomes.
- There is a whole section on "tunneling": when reacting to problems takes up all of your focus and removes time and brain space to think about bigger-picture ways to prevent problems. This happens to me all the time in life and at work. In general, this is a huge issue for researchers, who often end up focusing on e.g. conference deadlines and lose track of the bigger problem to be solved. Heath's proposal for how to avoid this is to use 'slack': time specifically dedicated to upstream thinking. I am trying to be more intentional about this by explicitly scheduling it.
- It's really important to use metrics to measure progress AND not to over-rely on metrics, which are always flawed and can result in worse outcomes than you started with. One interesting idea is that you should always consider "paired" metrics: if you have a quantity-based target, you should simultaneously be tracking a quality-based target, and vice versa.
- It's better to start off with a rough solution to a problem, have a system in place to track how you're doing, and use that to keep making the solution better, than it is to have a really good initial idea for a solution and no way to measure progress. ("We don’t succeed by foreseeing the future accurately. We succeed by ensuring that we’ll have the feedback we need to navigate.")
- We tend to hold upstream work to a higher standard than downstream work in a way that's not productive. For example, we don't care about costs when we're saving someone's life, but it's often not enough for preventative measures to result in fewer deaths -- they're expected to also save costs down the line.
- That said, a really hard open problem is figuring out who will pay for upstream work; often, the people who bear the cost for preventative work do not benefit from it.
April 23, 2020
What if we could travel back in time and stop disasters to make sure they never happen? You could prevent deaths, relay critical information, and prevent untold suffering if you just had a time machine. Or could you? Sometimes I think I would go back and no one would listen to me because I was asking them to change. Are we all stuck in an inevitable cycle of predestined events, or can we change the future meaningfully with actions today?
We don't need a time machine. We can change the future every day with our words and behaviors, and the butterfly effect magnifies our every activity in both good and bad ways. People today don't have to worry about polio because of the works of Dr. Jonas Salk. We may owe our lives today to of the quick thinking of an obscure Russian general, Stanislav Petrov, who discounted radar images showing a US attack and refused to order a counter-attack in 1983. Our parents have shaped our lives in many good and not-so-good ways, and we spend much of our lives trying to figure it out.
Upstream tries to look at how we can maximize impact today on problems of the future, and why that's preferable to only reacting to things as they happen.
Dan Heath, one-half of the popular Heath brothers writing team, has added to their great stable of thought provoking books like Decisive, Switch, Made to Stick, and the Power of Moments. Their website is chock full of helpful study guides, handouts, and additional materials that I recommend to any readers.
Heath uses the metaphor of upstream thinking to mean any action that's meant to prevent problems before they happen, or to at least lessen the harm caused by problems when they happen. Upstream thinking can be done hours before something is supposed to occur, days, weeks, months, or even generations. He sees three main reasons why we neglect to act more preventative, choosing to react to problems instead.
1- Problem Blindness. This is the belief that bad outcomes are natural and unavoidable, and therefore not a problem. It's easier and more tempting to focus on the problems right in front of us, and those tend to crowd out other more complicated problems involved with upstream thinking. Sometimes we have no choice but to react to crises when they are urgent enough. We pretend to be blind to things we know might happen but don't want to tackle by shrugging them off as "that's just the way things are."
2- Lack of Ownership. Many people see problems every day, but ignore them because they believe "that's not my problem." Especially with individualistic cultures such as America, the problems of others take second place to those of us and our in-group. In many cases the people most affected by a problem have limited power to solve them, while those that do have the power don't feel it's their place to solve them.
3- Tunneling. When the quantity of problems becomes overwhelming, people give up trying to solve them. Long term thinking gets tossed away and crisis management allows only the most immediate problems to get attention. People get tunnel vision, where only the short-term problems get temporary fixes, only to break again down the road.
One can see these three issues at work in government, business and personal decisions all the time. Environmental problems such as global warming get worse every year because people don't want to take ownership of them, and governments are worried only about short-term problems like winning elections. Businesses, too, are focused on short-term results and profitability, and all problems outside of the scope of their mission of maximizing profits are ignored.
There are several huge issues that Heath uncovers that make upstream planning and thinking more difficult than downstream action. First, the world is so complicated that it's hard to know all the repercussions of one series of actions. In the Back to the Future movie trilogy, Marty and Doc mess with the history through time travel, and find themselves dealing with a tangled web of unintended consequences from their actions. Heath tells the story of the frustrating attempts to manage an island ecosystem where rabbits and mice were overpopulated, then killed, poisoned, and subjected to viruses, Predators were introduced and the rabbits and mice finally all died, which led to weeds infesting the entire island because the rabbits weren't eating them. Systems are complicated and every action can have surprising results. The book details the famous cobra problem, where leaders in India tried to reduce the numbers of cobras by introducing a bounty for them, only resulting in people breeding them to get the bounty money, and then abandoning them when the bounty was discontinued, leading to more cobras than ever before.
The second and more confounding issue is how do you know preventative steps are working? If a disaster doesn't occur, how do you know it was your steps that prevented it? Or is it possible you just wasted a bunch of time and money on something that was never going to happen. Heath talks about the Y2K project, when computer experts all around the world tried to re-write computer code so that the systems wouldn't crash in the year 2000. Nothing happened that year, and people today still don't know if that was because of the work of the computer experts or the whole thing was overblown.
And third, there is the problem of getting people to pay for prevention that doesn't affect them right now, but maybe sometime in the distant future. Called the wrong pocket problem, this calls into question our very identities as a civilization. Do we pay today for things that will help our grandchildren? Our neighbors? People on the other side of the border who aren't like us? Getting people to sacrifice today for a future benefit is getting much harder for leaders to ask. Pandemics, mass shootings, natural disasters, financial collapses, and environmental calamities are all things that could all be prevented or helped ahead of time by laws, regulations, disaster plans and upstream thinking. But how do you get people to agree to do something?
There are some wonderful and inspiring stories in this book that illustrate the author's points very well.
- A group of Icelanders figured out how to change the culture of teenagers who were staying out late at night and drinking- not with strict punishments- but rather with upstream attempts by the entire community to engage the teens in better, healthier activities.
- A school system in Chicago figured out how to improve its graduation rates by looking hard at the freshman year and pouring resources into struggling students then, rather than giving up on them later. Getting the teachers on board gave them ownership of the problem of student drop-out rates, which many schools just figure are out of their control.
- A program called "Becoming a Man" uses cognitive behavioral therapy to help at-risk teen boys deal with anger and self-worth issues, keeping them off the streets in tough neighborhoods where the spiral of drugs and jail time awaits their peers.
- An employer prevented internet viruses by sending fake spam messages to its employees thus educating the 29% who erroneously clicked on dangerous messages and exposed the company to hacking.
- A program called the nurse-family partnership matches registered nurses with low-income, first-time mothers, so that they can educate the new parents on caring for infants and toddlers, potentially preventing a large set of problems. A similar program called Parents as Teachers is run by many school systems to provide screening and early childhood training to all new parents in their school districts.
Upstream focuses much of its attention on our health care system, where many of the incentives are in treatment instead of prevention. Public health initiatives such as immunization, hygiene, fluoridated water, and improved water and sewer systems have dropped the death rate from infectious diseases from 33% at the turn of the 20th century to less than 3% today. But public health spending is a tiny fraction of the huge bills run up by hospitals, drug companies, and diagnostic labs. Most of the health care dollars we spend today are to treat symptoms, and not address root causes such as obesity, substance abuse, stress, environmental contaminants, and poor dietary habits.
Much of the problem is with the incentive structure of the US health care system. Heath describes something called an Accountable Care Organization, where groups of doctors join together and their rate of pay is more determined by how healthy their patients are and not how many services they can provide. Preventing ailments like cancer, diabetes, and heart disease could be much more affordable than the current burden of tests, drugs, and surgeries. In my sixty some years of going to the doctor I cannot recall one time when they asked me about my lifestyle or my mental health. Most doctors have their little corner and lack ownership for anything bigger.
We live in an age of tunneling. As I write this the world is experiencing the Covid-19 pandemic, something that had been warned about by many public health professionals in prior years. But instead of preparing, the US government disbanded their pandemic response team, leaving them without a plan and facing chaos. Other crises loom in the future- global warming, an aging population, crumbling infrastructure, and debt financing that's pushed substantial money problems into the future. A book like this is just what we need for leaders all around the world who want to escape the tunnel and guide their organizations into the future. Focus more of your efforts upstream- solving problems that you might never personally have to face. Work on systems and not symptoms. Catch problems in early childhood and you save a human being a lifetime of making the same mistakes.
I give this book five out of five stars because it enlightened me to think more carefully about how to be effective. The following story is not from the book, but one I've heard before that pretty much sums things up. Not sure where it came from.
The “Parable of the River”
Once upon a time there was a small village on the edge of a river. The people there were good and life in the village was good. One day a villager noticed a baby floating down the river. The villager quickly swam out to save the baby from drowning. The next day this same villager noticed two babies in the river. He called for help, and both babies were rescued from the swift waters. And the following day four babies were seen caught in the turbulent current. And then eight, then more, and still more!
The villagers organized themselves quickly, setting up watchtowers and training teams of swimmers who could resist the swift waters and rescue babies. Rescue squads were soon working 24 hours a day. And each day the number of helpless babies floating down the river increased. The villagers organized themselves efficiently. The rescue squads were now snatching many children each day. While not all the babies, now very numerous, could be saved, the villagers felt they were doing well to save as many as they could each day. Indeed, the village priest blessed them in their good work. And life in the village continued on that basis.
One day, however, someone raised the question, "But where are all these babies coming from? Let’s organize a team to head upstream to find-out who’s throwing all of these babies into the river in the first place!"
The seeming logic of the community elders countered: "And if we go upstream who will operate the rescue operations? We need every concerned person here!"
"But don't you see," cried the one lone voice," if we find out who is throwing them in, we can stop the problem and no babies will drown! By going upstream we can eliminate the cause of the problem!" "It is too risky," said the village elders. And so the numbers of babies found floating in the river increase daily. Those saved increase, but those who drown increase even more.
We don't need a time machine. We can change the future every day with our words and behaviors, and the butterfly effect magnifies our every activity in both good and bad ways. People today don't have to worry about polio because of the works of Dr. Jonas Salk. We may owe our lives today to of the quick thinking of an obscure Russian general, Stanislav Petrov, who discounted radar images showing a US attack and refused to order a counter-attack in 1983. Our parents have shaped our lives in many good and not-so-good ways, and we spend much of our lives trying to figure it out.
Upstream tries to look at how we can maximize impact today on problems of the future, and why that's preferable to only reacting to things as they happen.
Dan Heath, one-half of the popular Heath brothers writing team, has added to their great stable of thought provoking books like Decisive, Switch, Made to Stick, and the Power of Moments. Their website is chock full of helpful study guides, handouts, and additional materials that I recommend to any readers.
Heath uses the metaphor of upstream thinking to mean any action that's meant to prevent problems before they happen, or to at least lessen the harm caused by problems when they happen. Upstream thinking can be done hours before something is supposed to occur, days, weeks, months, or even generations. He sees three main reasons why we neglect to act more preventative, choosing to react to problems instead.
1- Problem Blindness. This is the belief that bad outcomes are natural and unavoidable, and therefore not a problem. It's easier and more tempting to focus on the problems right in front of us, and those tend to crowd out other more complicated problems involved with upstream thinking. Sometimes we have no choice but to react to crises when they are urgent enough. We pretend to be blind to things we know might happen but don't want to tackle by shrugging them off as "that's just the way things are."
2- Lack of Ownership. Many people see problems every day, but ignore them because they believe "that's not my problem." Especially with individualistic cultures such as America, the problems of others take second place to those of us and our in-group. In many cases the people most affected by a problem have limited power to solve them, while those that do have the power don't feel it's their place to solve them.
3- Tunneling. When the quantity of problems becomes overwhelming, people give up trying to solve them. Long term thinking gets tossed away and crisis management allows only the most immediate problems to get attention. People get tunnel vision, where only the short-term problems get temporary fixes, only to break again down the road.
One can see these three issues at work in government, business and personal decisions all the time. Environmental problems such as global warming get worse every year because people don't want to take ownership of them, and governments are worried only about short-term problems like winning elections. Businesses, too, are focused on short-term results and profitability, and all problems outside of the scope of their mission of maximizing profits are ignored.
There are several huge issues that Heath uncovers that make upstream planning and thinking more difficult than downstream action. First, the world is so complicated that it's hard to know all the repercussions of one series of actions. In the Back to the Future movie trilogy, Marty and Doc mess with the history through time travel, and find themselves dealing with a tangled web of unintended consequences from their actions. Heath tells the story of the frustrating attempts to manage an island ecosystem where rabbits and mice were overpopulated, then killed, poisoned, and subjected to viruses, Predators were introduced and the rabbits and mice finally all died, which led to weeds infesting the entire island because the rabbits weren't eating them. Systems are complicated and every action can have surprising results. The book details the famous cobra problem, where leaders in India tried to reduce the numbers of cobras by introducing a bounty for them, only resulting in people breeding them to get the bounty money, and then abandoning them when the bounty was discontinued, leading to more cobras than ever before.
The second and more confounding issue is how do you know preventative steps are working? If a disaster doesn't occur, how do you know it was your steps that prevented it? Or is it possible you just wasted a bunch of time and money on something that was never going to happen. Heath talks about the Y2K project, when computer experts all around the world tried to re-write computer code so that the systems wouldn't crash in the year 2000. Nothing happened that year, and people today still don't know if that was because of the work of the computer experts or the whole thing was overblown.
And third, there is the problem of getting people to pay for prevention that doesn't affect them right now, but maybe sometime in the distant future. Called the wrong pocket problem, this calls into question our very identities as a civilization. Do we pay today for things that will help our grandchildren? Our neighbors? People on the other side of the border who aren't like us? Getting people to sacrifice today for a future benefit is getting much harder for leaders to ask. Pandemics, mass shootings, natural disasters, financial collapses, and environmental calamities are all things that could all be prevented or helped ahead of time by laws, regulations, disaster plans and upstream thinking. But how do you get people to agree to do something?
There are some wonderful and inspiring stories in this book that illustrate the author's points very well.
- A group of Icelanders figured out how to change the culture of teenagers who were staying out late at night and drinking- not with strict punishments- but rather with upstream attempts by the entire community to engage the teens in better, healthier activities.
- A school system in Chicago figured out how to improve its graduation rates by looking hard at the freshman year and pouring resources into struggling students then, rather than giving up on them later. Getting the teachers on board gave them ownership of the problem of student drop-out rates, which many schools just figure are out of their control.
- A program called "Becoming a Man" uses cognitive behavioral therapy to help at-risk teen boys deal with anger and self-worth issues, keeping them off the streets in tough neighborhoods where the spiral of drugs and jail time awaits their peers.
- An employer prevented internet viruses by sending fake spam messages to its employees thus educating the 29% who erroneously clicked on dangerous messages and exposed the company to hacking.
- A program called the nurse-family partnership matches registered nurses with low-income, first-time mothers, so that they can educate the new parents on caring for infants and toddlers, potentially preventing a large set of problems. A similar program called Parents as Teachers is run by many school systems to provide screening and early childhood training to all new parents in their school districts.
Upstream focuses much of its attention on our health care system, where many of the incentives are in treatment instead of prevention. Public health initiatives such as immunization, hygiene, fluoridated water, and improved water and sewer systems have dropped the death rate from infectious diseases from 33% at the turn of the 20th century to less than 3% today. But public health spending is a tiny fraction of the huge bills run up by hospitals, drug companies, and diagnostic labs. Most of the health care dollars we spend today are to treat symptoms, and not address root causes such as obesity, substance abuse, stress, environmental contaminants, and poor dietary habits.
Much of the problem is with the incentive structure of the US health care system. Heath describes something called an Accountable Care Organization, where groups of doctors join together and their rate of pay is more determined by how healthy their patients are and not how many services they can provide. Preventing ailments like cancer, diabetes, and heart disease could be much more affordable than the current burden of tests, drugs, and surgeries. In my sixty some years of going to the doctor I cannot recall one time when they asked me about my lifestyle or my mental health. Most doctors have their little corner and lack ownership for anything bigger.
We live in an age of tunneling. As I write this the world is experiencing the Covid-19 pandemic, something that had been warned about by many public health professionals in prior years. But instead of preparing, the US government disbanded their pandemic response team, leaving them without a plan and facing chaos. Other crises loom in the future- global warming, an aging population, crumbling infrastructure, and debt financing that's pushed substantial money problems into the future. A book like this is just what we need for leaders all around the world who want to escape the tunnel and guide their organizations into the future. Focus more of your efforts upstream- solving problems that you might never personally have to face. Work on systems and not symptoms. Catch problems in early childhood and you save a human being a lifetime of making the same mistakes.
I give this book five out of five stars because it enlightened me to think more carefully about how to be effective. The following story is not from the book, but one I've heard before that pretty much sums things up. Not sure where it came from.
The “Parable of the River”
Once upon a time there was a small village on the edge of a river. The people there were good and life in the village was good. One day a villager noticed a baby floating down the river. The villager quickly swam out to save the baby from drowning. The next day this same villager noticed two babies in the river. He called for help, and both babies were rescued from the swift waters. And the following day four babies were seen caught in the turbulent current. And then eight, then more, and still more!
The villagers organized themselves quickly, setting up watchtowers and training teams of swimmers who could resist the swift waters and rescue babies. Rescue squads were soon working 24 hours a day. And each day the number of helpless babies floating down the river increased. The villagers organized themselves efficiently. The rescue squads were now snatching many children each day. While not all the babies, now very numerous, could be saved, the villagers felt they were doing well to save as many as they could each day. Indeed, the village priest blessed them in their good work. And life in the village continued on that basis.
One day, however, someone raised the question, "But where are all these babies coming from? Let’s organize a team to head upstream to find-out who’s throwing all of these babies into the river in the first place!"
The seeming logic of the community elders countered: "And if we go upstream who will operate the rescue operations? We need every concerned person here!"
"But don't you see," cried the one lone voice," if we find out who is throwing them in, we can stop the problem and no babies will drown! By going upstream we can eliminate the cause of the problem!" "It is too risky," said the village elders. And so the numbers of babies found floating in the river increase daily. Those saved increase, but those who drown increase even more.
January 27, 2022
You know that old saying, an ounce of prevention is worth a pound of cure? Dan Heath drives that home in Upstream - and that is the name of the process Heath suggests using to get ahead of the problems and challenges that institutions and companies face in their pursuit of excellence. Whether it is cracked sidewalks or poor customer or a badly designed website, considering the problem before it happens can pay off in the long run. By anticipating issues and working proactively to prevent them, customer service can improve and staff can be more productive. There are plenty of good examples in the book, and the application of upstreaming can take a whole lot of work, but the results will be worth it.
June 29, 2022
Great perspective and reminder - prevention is better than treatment. I look forward to thinking about how this applies to my personal/family life, work productivity, and church service.
December 25, 2019
I got an advanced review copy (digital) of the book via NetGalley.. as with all the other Heath brothers book, I loved the book a lot. I have gifted 100’s of copies of Switch, Decisive, the power of moments and made to stick and it looks like I will be giving away 100’s of copied of this book to my friends, family and customers as well.
What I liked about the book:
- the book deals with the difficult question of how can we make prevention an important topic for all rather than just cure what is wrong.
- the framework that is suggested looks to be interesting and worth exploring.
- the case studies presented in the book are fresh and relevant!
What could have been different:
- One thing that I felt could have been done differently is for the author to have put together a simple visual depiction of the framework that we could remember or print a copy of and have it on our desks.. this would have made the book even more memorable!
- would be great if there was a community of change agents who want to do upstream work created! Since this is hard work, we could support & learn from each other!!
Highly recommended!!
What I liked about the book:
- the book deals with the difficult question of how can we make prevention an important topic for all rather than just cure what is wrong.
- the framework that is suggested looks to be interesting and worth exploring.
- the case studies presented in the book are fresh and relevant!
What could have been different:
- One thing that I felt could have been done differently is for the author to have put together a simple visual depiction of the framework that we could remember or print a copy of and have it on our desks.. this would have made the book even more memorable!
- would be great if there was a community of change agents who want to do upstream work created! Since this is hard work, we could support & learn from each other!!
Highly recommended!!
March 12, 2020
“An ounce of prevention is worth a pound of cure.”
Dan Heath's message is that we should solve problems at their root (upstream) rather than downstream when we are hit with the reality - we should try to intercept the causes of a problem rather than just trying to tackle the product. In this context he is discussing methodologies such as system thinking, and how we should leverage knowledge through data - as well as how we should not. He is discussing the many reasons why we fail to solve the problems at the root/upstream such as incentive structures, how prevention is boring compared to acting on problem once it arises et cetera. Likewise he is showing how complicated it quickly becomes.
This book does NOT deliver a "how to" guide.
Rather, it strives to illuminate the challenges and delivers inspiration on how we can think around it.
Also, there is a lot of focus on the US, and how the US fare particularly purely.
Dan Heath's message is that we should solve problems at their root (upstream) rather than downstream when we are hit with the reality - we should try to intercept the causes of a problem rather than just trying to tackle the product. In this context he is discussing methodologies such as system thinking, and how we should leverage knowledge through data - as well as how we should not. He is discussing the many reasons why we fail to solve the problems at the root/upstream such as incentive structures, how prevention is boring compared to acting on problem once it arises et cetera. Likewise he is showing how complicated it quickly becomes.
This book does NOT deliver a "how to" guide.
Rather, it strives to illuminate the challenges and delivers inspiration on how we can think around it.
Also, there is a lot of focus on the US, and how the US fare particularly purely.
January 31, 2024
It grew on me as I read, I liked all the examples provided (esp. about Chicago public schools!!) pretty inspiring but still more fluff/entertaining than making me confident I could actually apply any of this to my own life
December 1, 2020
A business book, but an excellent read for anyone who is solving problems of any sort.
May 18, 2022
Fantastic examples of how problems can be prevented and not just reacted to. Plenty of information around why organisations do not work like this and what we can do to change it.
Enjoyable to read too
Enjoyable to read too
March 28, 2023
Super insightful and thought provoking ideas throughout this book. It offers a different way of thinking about problems and solution-searching and highlights the issues we will run into as a society unless we shift “upstream” in our thinking about the problems we currently face or are anticipating facing in the future.
December 29, 2020
A very good book by Dan Heath.
The author does a very commendable job of describing how as a society we tend to value reacting to problems and solving them downstream, rather than having the wisdom to think long term and prevent problems from happening at the first place.
In a story he shared of kids drowning in a river, we are so focused on saving kids downstream that we do not give attention to why do they need saving at all.
Something to ponder over in various walks of life as almost all of us more often than not give importance to the urgent over the important. For example we all know the importance of a healthy diet, sleep and exercise regimen but come any sort of deadline we will burn the midnight oil compromising our routine telling ourselves "this one last time and from next time i will plan better and not disrupt my routine" or for example we make decisions under time pressure when we can take sometime more in advance and think through the issue at hand and act on it properly.
He goes on to share his insights into why it is difficult for most of us to do upstream thinking - blindness to the problem, lack of ownership and tunnelling.
He takes examples of organisations such as Expedia, carpet making firm Interface, Chicago public school system, the story of how the car seat came about for kids to show how these systems were previously either unaware of the problem, no one felt that this is something i own or they were so focused on the short term that they never took their necks out of the sand and looked around. But through thoughtfulness and courage of people, these systems started doing upstream thinking and made changes so that Expedia instead of focusing on giving a shorter customer interaction time for every ticket raised focused on reducing the customer tickets overall, the carpet making firm figured out a way to be environmentally responsible and act as a leader for green practices, the Chicago public system focused on keeping children in the school instead of just thinking people will drop out come high school (these had downstream effects of a more crime free society - something we do not realise because the rewards for upstream efforts are not directly tangible) and the car seat movement which ultimately led to the law in the US for car seat for all kids saving uncountable lives from perishing before they reached fruition.
The book then focuses on what needs to change to enable upstream thinking in organisations
1. Uniting the right people
2. Changing the system - shaping the water: The way systems are designed will have an influence on the outcome. A system designed to promote healthy habits such as good food, a space to exercise etc will ultimately lead to healthier individuals.
3. Getting close to the problem
4. Getting early data (warning) of the problem: Several elevator companies offer smart elevators today which warn in case of an impeding damage so that maintenance people can come and fix the elevator before someone gets stuck in them.
5. Having paired measures so that you know you are succeeding
6. Closing feedback loops so that what you do in your actions are not causing any other harm
7. Figuring out who will pay for the upstream actions: Who will pay for what does not happen!
The time has come for us to realise that most of the times we need the hero who watches out for us, who ensures we don't get into non value add problems, a quieter breed who does not come when we are drowning but through their thoughtfulness ensure that we do not drown! A hero we need, whether we deserve such heroes in our lives are upto our actions! A hero who actively fights for a world where rescues are seldom required.
A very interesting and quick read. Highly recommend.
The author does a very commendable job of describing how as a society we tend to value reacting to problems and solving them downstream, rather than having the wisdom to think long term and prevent problems from happening at the first place.
In a story he shared of kids drowning in a river, we are so focused on saving kids downstream that we do not give attention to why do they need saving at all.
Something to ponder over in various walks of life as almost all of us more often than not give importance to the urgent over the important. For example we all know the importance of a healthy diet, sleep and exercise regimen but come any sort of deadline we will burn the midnight oil compromising our routine telling ourselves "this one last time and from next time i will plan better and not disrupt my routine" or for example we make decisions under time pressure when we can take sometime more in advance and think through the issue at hand and act on it properly.
He goes on to share his insights into why it is difficult for most of us to do upstream thinking - blindness to the problem, lack of ownership and tunnelling.
He takes examples of organisations such as Expedia, carpet making firm Interface, Chicago public school system, the story of how the car seat came about for kids to show how these systems were previously either unaware of the problem, no one felt that this is something i own or they were so focused on the short term that they never took their necks out of the sand and looked around. But through thoughtfulness and courage of people, these systems started doing upstream thinking and made changes so that Expedia instead of focusing on giving a shorter customer interaction time for every ticket raised focused on reducing the customer tickets overall, the carpet making firm figured out a way to be environmentally responsible and act as a leader for green practices, the Chicago public system focused on keeping children in the school instead of just thinking people will drop out come high school (these had downstream effects of a more crime free society - something we do not realise because the rewards for upstream efforts are not directly tangible) and the car seat movement which ultimately led to the law in the US for car seat for all kids saving uncountable lives from perishing before they reached fruition.
The book then focuses on what needs to change to enable upstream thinking in organisations
1. Uniting the right people
2. Changing the system - shaping the water: The way systems are designed will have an influence on the outcome. A system designed to promote healthy habits such as good food, a space to exercise etc will ultimately lead to healthier individuals.
3. Getting close to the problem
4. Getting early data (warning) of the problem: Several elevator companies offer smart elevators today which warn in case of an impeding damage so that maintenance people can come and fix the elevator before someone gets stuck in them.
5. Having paired measures so that you know you are succeeding
6. Closing feedback loops so that what you do in your actions are not causing any other harm
7. Figuring out who will pay for the upstream actions: Who will pay for what does not happen!
The time has come for us to realise that most of the times we need the hero who watches out for us, who ensures we don't get into non value add problems, a quieter breed who does not come when we are drowning but through their thoughtfulness ensure that we do not drown! A hero we need, whether we deserve such heroes in our lives are upto our actions! A hero who actively fights for a world where rescues are seldom required.
A very interesting and quick read. Highly recommend.
December 6, 2021
I had to read this book for work and it wasn’t very good
July 27, 2021
This is the first Dan Heath book that I've read, but is a great "business bro" analysis about many of the prevention and systems-change dynamics I've been thinking about a lot in our consulting practice. A few nuggets that I'll likely come back to:
- "When we create organizations, we're doing it to give people focus. We're essentially giving them a license to be myopic. We're saying: This is your problem. Define your mission and create your strategy and align your resources to solve that problem. And you have the divine right to ignore all of the other stuff that doesn't align with that." Mark Okerstrom, Expedia CFO
- "But while upstream solutions are generally more desirable, they're also more complex and ambiguous." (9)
- "'Problem blindness'" -- the belief that negative outcomes are natural or inevitable. (23)
- "To succeed upstream, leaders must: detect problems early, target leverage points in complex systems, find reliable ways to measure, pioneer new ways of working together, and embed their success into systems to give them permanence." (29)
- "What's odd about upstream work is that, despite the enormous stakes, it's often optional. With downstream activity -- the rescues and responses and reactions -- the work is demanded of us. A doctor can't opt out of a heart surgery; a day care worker can't opt out of a diaper change. By contrast, upstream work is chosen, not demanded." (41)
- The psychologists Eldar Shafir and Sendhil Mullainathan, in their book Scarcity, call this 'tunneling': When people are juggling a lot of problems, they give up trying to solve them all." (59)
- "To succeed in upstream efforts, you need to surround the problem. Meaning you need to attract people who can address all the key dimensions of the issue." (82)
- "Systems are machines that determine probabilities." (102)
- "Systems change starts with a spark of courage... Success comes when the right things happen by default--not because of individual passion or heroism." (109)
- Seton Hall Medical School rethinking how doctors are trained with a community focus (130)
- "Nothing is easy. The world is complex and there are no quick fixed. But if I can learn to uncross my arms and extend my hands, I can be someone who eases suffering rather than ignores it." (132)
- “Systems can’t be controlled, but they can be designed and redesigned. We can’t surge forward with certainty into a world of no surprises, but we can expect surprises and learn from them and event profit from them... We can’t control systems or figure them out. But we can dance with them!” - Systems expert Donella Meadows (188)
- 3 lessons:
1. "Be impatient for action but patient for outcomes"
2. "Macro starts with micro"
3. "Favor scoreboards over pills"
- "In the social sector, we've eventually got to shift from a mind-set of 'scaling a specific program by reproducing it faithfully' to 'owning a problem and adapting a program as needed to achieve results." (250)
- "When we create organizations, we're doing it to give people focus. We're essentially giving them a license to be myopic. We're saying: This is your problem. Define your mission and create your strategy and align your resources to solve that problem. And you have the divine right to ignore all of the other stuff that doesn't align with that." Mark Okerstrom, Expedia CFO
- "But while upstream solutions are generally more desirable, they're also more complex and ambiguous." (9)
- "'Problem blindness'" -- the belief that negative outcomes are natural or inevitable. (23)
- "To succeed upstream, leaders must: detect problems early, target leverage points in complex systems, find reliable ways to measure, pioneer new ways of working together, and embed their success into systems to give them permanence." (29)
- "What's odd about upstream work is that, despite the enormous stakes, it's often optional. With downstream activity -- the rescues and responses and reactions -- the work is demanded of us. A doctor can't opt out of a heart surgery; a day care worker can't opt out of a diaper change. By contrast, upstream work is chosen, not demanded." (41)
- The psychologists Eldar Shafir and Sendhil Mullainathan, in their book Scarcity, call this 'tunneling': When people are juggling a lot of problems, they give up trying to solve them all." (59)
- "To succeed in upstream efforts, you need to surround the problem. Meaning you need to attract people who can address all the key dimensions of the issue." (82)
- "Systems are machines that determine probabilities." (102)
- "Systems change starts with a spark of courage... Success comes when the right things happen by default--not because of individual passion or heroism." (109)
- Seton Hall Medical School rethinking how doctors are trained with a community focus (130)
- "Nothing is easy. The world is complex and there are no quick fixed. But if I can learn to uncross my arms and extend my hands, I can be someone who eases suffering rather than ignores it." (132)
- “Systems can’t be controlled, but they can be designed and redesigned. We can’t surge forward with certainty into a world of no surprises, but we can expect surprises and learn from them and event profit from them... We can’t control systems or figure them out. But we can dance with them!” - Systems expert Donella Meadows (188)
- 3 lessons:
1. "Be impatient for action but patient for outcomes"
2. "Macro starts with micro"
3. "Favor scoreboards over pills"
- "In the social sector, we've eventually got to shift from a mind-set of 'scaling a specific program by reproducing it faithfully' to 'owning a problem and adapting a program as needed to achieve results." (250)
June 24, 2022
This book idea is simple. Be proactive and solve the root cause of problems instead of reacting to them as they occur. The book starts with a hook story. Here is the story:
You and a friend are having a picnic by the side of a river. Suddenly you hear a shout from the direction of the water—a child is drowning. Without thinking, you both dive in, grab the child, and swim to shore. Before you can recover, you hear another child cry for help. You and your friend jump back in the river to rescue her as well. Then another struggling child drifts into sight … and another … and another. The two of you can barely keep up. Suddenly, you see your friend wading out of the water, seeming to leave you alone. “Where are you going?” you demand. Your friend answers, “I’m going upstream to tackle the guy who’s throwing all these kids in the water.”
So, the goal of the author is to convince the reader to shift from dealing with the symptoms of problems, to fixing them. Then, the author dwell on the same idea by showing random case studies throughout the book. I certainly learned something from the book, but I dislike the way these nonfiction books are written. Most of the books have good ideas impeded in them, but somehow, they always present boring examples to support the idea of interest.
Few highlights from the book:
Good intentions guarantee nothing
“Inattentional blindness,” a phenomenon in which our careful attention to one task leads us to miss important information that’s unrelated to that task
The need for heroism is usually evidence of systems failure
If you rig up a system that makes it easy for me to move the world, then I shall move the world!
The cobra effect occurs when an attempted solution to a problem makes the problem worse
Reactive efforts succeed when problems happen and they’re fixed. Preventive efforts succeed when nothing happens. Who will pay for what does not happen?
An OK Book
You and a friend are having a picnic by the side of a river. Suddenly you hear a shout from the direction of the water—a child is drowning. Without thinking, you both dive in, grab the child, and swim to shore. Before you can recover, you hear another child cry for help. You and your friend jump back in the river to rescue her as well. Then another struggling child drifts into sight … and another … and another. The two of you can barely keep up. Suddenly, you see your friend wading out of the water, seeming to leave you alone. “Where are you going?” you demand. Your friend answers, “I’m going upstream to tackle the guy who’s throwing all these kids in the water.”
So, the goal of the author is to convince the reader to shift from dealing with the symptoms of problems, to fixing them. Then, the author dwell on the same idea by showing random case studies throughout the book. I certainly learned something from the book, but I dislike the way these nonfiction books are written. Most of the books have good ideas impeded in them, but somehow, they always present boring examples to support the idea of interest.
Few highlights from the book:
Good intentions guarantee nothing
“Inattentional blindness,” a phenomenon in which our careful attention to one task leads us to miss important information that’s unrelated to that task
The need for heroism is usually evidence of systems failure
If you rig up a system that makes it easy for me to move the world, then I shall move the world!
The cobra effect occurs when an attempted solution to a problem makes the problem worse
Reactive efforts succeed when problems happen and they’re fixed. Preventive efforts succeed when nothing happens. Who will pay for what does not happen?
An OK Book
June 24, 2021
The book provides good takeaways about preventing problems (upstream) versus reacting to problems (downstream). There are three barriers to upstream thinking:
* Problem blindness - The belief that negative outcomes are natural or inevitable (like meetings are a waste of time but that's how organizations function).
* A lack of ownership - All parties say "that's not mine to fix."
* Tunneling - When juggling lots of problems, people give up trying to solve them all (like "they have bigger problems to worry about than how to make meetings more engaging").
The author provides examples of how people overcame the resistance to this downstream thinking, like hiring a facilitator to run the meetings. The facilitator asked each participant to say something positive that happened in the previous week. As people became comfortable with doing this, they realized they had a lot of information to share with their colleagues (how to deal with difficult customers or how to process something more quickly). Eventually, the meetings became engaging and useful to all the participants.
* Problem blindness - The belief that negative outcomes are natural or inevitable (like meetings are a waste of time but that's how organizations function).
* A lack of ownership - All parties say "that's not mine to fix."
* Tunneling - When juggling lots of problems, people give up trying to solve them all (like "they have bigger problems to worry about than how to make meetings more engaging").
The author provides examples of how people overcame the resistance to this downstream thinking, like hiring a facilitator to run the meetings. The facilitator asked each participant to say something positive that happened in the previous week. As people became comfortable with doing this, they realized they had a lot of information to share with their colleagues (how to deal with difficult customers or how to process something more quickly). Eventually, the meetings became engaging and useful to all the participants.
February 21, 2021
This is a 250-page book, and it reads super fast. Still, it could have been 50 pages shorter and gotten the message across. Some of the examples were absolutely fascinating, but a couple of them felt more like overkill or told in too many words. He relies heavily on a few other books I've read and does a good job of summarizing a few of their main points, since they're both drier than this one: Thinking Fast and Slow by Daniel Kahneman and Thinking in Systems by Donella Meadows. I appreciated the reminder of those authors' insights.
The questions themselves starting with Chapter 5 are pretty useful for anyone who solves problems for a living, which pretty much involves the majority of us! Hang in there for the first four chapters, which like I already said, can get a bit wordy.
My favorite part was the series of "tests" for short/long term metrics in Ch 9, "How will you know you're succeeding?" I will certainly be using those in the near future for various projects.
My favorite quote he quoted that I will be telling other people is: "Be impatient for action but patient with outcomes." Ah, patience, that virtue again... such an applicable quote for a ton of areas of our lives.
Overall, if you are interested in a decently written recent book on problem solving, this one isn't a bad choice.
The questions themselves starting with Chapter 5 are pretty useful for anyone who solves problems for a living, which pretty much involves the majority of us! Hang in there for the first four chapters, which like I already said, can get a bit wordy.
My favorite part was the series of "tests" for short/long term metrics in Ch 9, "How will you know you're succeeding?" I will certainly be using those in the near future for various projects.
My favorite quote he quoted that I will be telling other people is: "Be impatient for action but patient with outcomes." Ah, patience, that virtue again... such an applicable quote for a ton of areas of our lives.
Overall, if you are interested in a decently written recent book on problem solving, this one isn't a bad choice.
November 6, 2020
A fantastic book, I enjoyed the author´s approach to the art of prevention and the quote on: "There are many organizations that are dedicated to help the poor, but how many to prevent them?"
This book gives great examples when it comes to solving problems and being proactive about them.
This book gives great examples when it comes to solving problems and being proactive about them.
November 18, 2020
Good Insights, but unnecessarily stretched.
February 7, 2022
Excellant read!
Encourages to solve problems upstream and make systemic fixes rather than battling the same issues over and over again. Author has done good research and presents great real life case studies of upstream thinking & benefits.
I feel this book is applicable to people in every field and is a solid recommend.
I did the audiobook and feel it's a great choice for audio - as it primarly consists of case studies which may be more fun to listen than to read - IMHO :)
Encourages to solve problems upstream and make systemic fixes rather than battling the same issues over and over again. Author has done good research and presents great real life case studies of upstream thinking & benefits.
I feel this book is applicable to people in every field and is a solid recommend.
I did the audiobook and feel it's a great choice for audio - as it primarly consists of case studies which may be more fun to listen than to read - IMHO :)
May 21, 2020
Some motivational ideas on taking a proactive approach to situations. Positive thinking has you going upstream.
April 16, 2021
Great way to rethink change
I liked this book so much I’ve ordered a hard copy for reference. Gets you think about how you can solve things before they become problems.
I liked this book so much I’ve ordered a hard copy for reference. Gets you think about how you can solve things before they become problems.
August 17, 2022
4.3
Very valuable insight about addressing the cause of a problem, instead of only a symptom.
Very valuable insight about addressing the cause of a problem, instead of only a symptom.
Displaying 1 - 30 of 672 reviews