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PubMed · 11246924

The Nut Island effect. When good teams go wrong.

Abstract

The team that operated the Nut Island sewage treatment plant in Quincy, Massachusetts, was every manager's dream. Members of the group performed difficult, dangerous work without complaint. They needed little supervision. They improvised their way around operational difficulties and budgetary constraints. They were dedicated to the organization's mission. But their hard work led to catastrophic failure. How could such a good team go so wrong? In this article, the author tells the story of the Nut Island plant and identifies a common, yet destructive organizational dynamic that can strike any business. The Nut Island effect begins with a deeply committed team that is isolated from a company's mainstream activities. Pitted against this team is its senior management. Preoccupied with high-visibility problems, management assigns the team a vital but behind-the-scenes task. Allowed considerable autonomy, team members become adept at managing themselves. Management takes the team's self-sufficiency for granted and ignores team members when they ask for help. When trouble strikes and management is unresponsive, team members feel betrayed and develop an us-against-the-world mentality. They stay out of management's line of sight, hiding problems. The team begins to make up its own rules, which mask grave problems in its operations. Management, disinclined in the first place to focus on the team's work, is easily misled by team members' skillful disguising of its performance deficiencies. The resulting stalemate typically can be broken only by an external event. The Nut Island story serves as a warning to managers who concentrate their efforts on their organization's most visible shortcomings: sometimes the most debilitating problems are the ones we can't see.

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BibTeXRIS

P F Levy. 2001. The Nut Island effect. When good teams go wrong.. https://pubmed.ncbi.nlm.nih.gov/11246924/

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ACOG Committee Opinion No. 359: commercial enterprises in medical practice.

Increasing numbers of physicians sell and promote both medical and nonmedical products as part of their practices. Physicians always have rendered advice and treatment for a fee, and this practice is appropriate. It is unethical under most circumstances, however, for physicians to sell or promote medical or nonmedical products or services for their financial benefit. The following activities are considered unethical: sale of prescription drugs to be used at home, sale or promotion of nonprescription medicine, sale or promotion of presumptively therapeutic agents that generally are not accepted as part of standard medical practice, sale or promotion of non-health-related items, recruitment of patients or other health care professionals into multilevel marketing arrangements, and sale or promotion of any product in whose sale the physician has a significant financial interest. It is ethical and appropriate, however, to sell products to patients as follows: sale of devices or drugs that require professional administration in the office setting; sale of therapeutic agents, when no other facilities can provide them at reasonable convenience and at reasonable cost; sale of products that clearly are external to the patient-physician relationship, when such a sale would be considered appropriate in an external relationship; and sale of low-cost products for the benefit of community organizations. A rationale is provided for both the prohibited activities and exceptions.

Commerce↗