Success 101, according to John Balz

Andrew Chrucky
August 29, 2002

John Balz, in "Success 101," has written an accurate account of the recent history of the University of Chicago from a business point of view, and he has concluded correctly that the U of C business is a success. Yet, the whole piece leaves me profoundly dissatisfied. Why? Let me illustrate this with a fairy tale:

Once upon a time there was a huge medical complex called Laputa. It had five medical divisions with countless subdivisions. All new patients had to go to the C division in which they were given various forms of placebos and 21 units of aspirin. Laputa operated on a triage system. It welcomed the healthiest patients, and tried to reject the unhealthy ones. But it had to meet quotas to stay financially sound -- so many unhealthy patients were admitted. They were serviced, in great part, by medical students and various itinerant doctors. Everyone wanted more healtier patients. The trouble was that the aspirin was hard to swallow, so patients preferred other medical facilities.

One year, the chief medical officer (CMO), whose name was Sun, and who wanted to expand the medical complex, decided on a scheme to get more and healthier patients. Since the final decision lay with a doctor's Senate, he lobbied them for increased quotas for the C division and for lowering of the aspirin dose from 21 to 18 or 15 units, and he recommended a sugar-coating as well. He reasoned that this would attract a larger pool of patients, from which only the healthiest could be selected. The larger quotas would be offset by lesser care required.

The newspapers picked up on this story with a clever reference to the sugar-coated aspirin as "lollipops." Well, everyone got upset: the doctors, the patients, and even the ex-patients. Ex-patients, who swore by aspirin and suspected the dispensing of placebos, protested its diminution; doctors did not want to see a greater number of patients; and the patients themselves objected to lollipops -- they even staged a great lollipop sit-in.

The Board of Trustees of Laputa looked at this uproar with apprehensions. They saw Sun's bungling attempts to appease everyone as a failure, and dismissed him. A new CMO was recruited, Don -- a polished, easy-going, smooth-talking, music-loving doctor, whose first order of business was to start a 2 billion dollar fund-raiser. And lo, and behold, more and healtier patients started coming. New buildings were projected, and a local journalist, John Bots, wrote a story about the success of Don and Laputa.

The problem with Bots' narrative was that, despite the accusations of a scam operation, he never talked about or evaluated the charge of placebos and the projected elimination of aspirin. After all, he was not a doctor -- so how could he report on a medical innovation which was the result of a "critical discussion" among the doctors. All he knew was that Don and Laputa were a great business success.