September 22, 2015

Also consider solutions that manage the problem

Confronted with a problem most of us are quick to think of solutions as ways to eliminate it. But those aren’t the only solutions. At times, you may be better off with a solution that helps you control how the problem unfolds, so also consider solutions that manage the problem.

Manage the problem – an example in healthcare

Dr. Gilbert Welch is an academic physician at Dartmouth who just released a great book: Less Medicine, More Health. The book challenges seven commonly held assumptions. One of those is that it’s always better to try to eliminate a problem. Well, that’s not necessarily true.

Welch considers the case of angina patients: people suffering of a partial obstruction of the coronary arteries. There are various ways to go about fixing the condition. One is mechanical intervention: either surgery or removal of the obstruction through balloon angioplasty. Another approach to manage it: through medical therapy, cholesterol- and blood-pressure lowering medications, and a healthy lifestyle. Patients who go with the first approach are no less likely to die or have a heart attack than patients who go with the second. The advantage of the fixing approach is that patients report getting better quicker, but two or three years later, the two groups feel the same. And there is a price to pay for this: as mechanical intervention, like any surgery, has an inherent risks.

This leads Welch to conclude: “if I developed stable angina, I’d start with medical management.” If that failed to control symptoms, then he would consider the balloon angioplasty.

Manage the problem – an example in product design

Consider design differences between German and Soviet tanks during the Second World War. Both were facing the problem of preventing their tracks from getting thrown. The German system did just that: it prevented the problem from occurring through a mechanism that was complicated and failure prone.

The Soviet system, on the other hand, was more rudimentary. Instead of preventing the track from getting thrown, it let it get reasonably untracked. But, at each revolution, it whacked the track back into position through a simple and reliable system.

(Or, at least, this is how I understood it. My father gave me this example last year but he died shortly after and I never got to validate it; if you are a tank expert and there is mistake in the description above, please let me know.)

The take away is that, while solutions that manage the problem might seem less effective or less elegant than those that eliminate it, they can be just as attractive depending on the specific conditions of your situation. I’m not advocating for you to always favor them, I’m just saying that you should consider them as possible solutions.


Welch, H. G. (2015). Less medicine more health: 7 assumptions that drive too much medical care, Beacon Press. [pp. 28–50].