Improvement Insights Blog

My childhood doctor did it all. Now I almost never see a doctor. Are You Doing Black or Green Belt work, or “No Belt” work?

“When I was growing up as a kid, our family doctor, Dr. Pierce (and what an unfortunate name)… anyway, Dr. Pierce was actually a MASH 4077 kind of a doctor, right? He was he was in Korea [where] they were doing meatball surgery. But back in the 50s, he’d come in and take your temperature, check your pulse, and he would give you the shots and anything else that was there: write the prescriptions out long hand and rip them off a pad and hand them to you. He did it all.

“Now as the years went along, the nurses started checking your temperature and your blood pressure and everything else, and then the doctor would come in. Then it shifted even more so that a nurse might come in, but [mostly] a physician assistant; I almost never see a doctor anymore.

“You don’t see [physicians], you see physician assistants. All of that work that was kind of mundane and normal shifted off to other folks to do it, people who could do it. At my pharmacy, my pharmacist gives out vaccinations. In the old days you had to go to the doctor to get a vaccination, right? You couldn’t go to a pharmacy and get that. So all of this we’ve been spreading out and pushing down that work.

“Now, one of the places I don’t see this happening is in the Six Sigma world. We’ve got Black Belts drawing charts; one guy said “I’ve become the chart monkey for my company.” Uh… no. We should hang on to the power of the Black Belt and let them do their job and [letting] the Green Belts do their job, but we should also start to farm some of this other stuff out, right? So maybe we should have Yellow Belts doing improvement projects. Maybe we should have people that are “no belts” monitoring the process using control charts and the QI Macros. Maybe we should push all of that work that doesn’t belong with the Black Belt and the Green Belt out to the people who can do it, and give them some software and tools to make it easy. This is not hard, but I think we’ve become trapped in old ways of doing things and we need to get smarter.

“I’m Jay Arthur, author of “Lean Six Sigma Demystified” and QI Macros [software]. That’s my Improvement Insight for this week. Let’s go out and improve something this week.”