The Art of Doing Nothing

Everyone knows someone like John. He is a successful, 50-something executive who is well-liked and agreeable. He’s not known for flash, he’s not especially brilliant or charismatic, but he’s dependable in an old-shoe kind of way that is refreshing in this age of in-your-face self-promotion and manic fixation with activity and goal setting.

Still, when you stop and think of what John is known for, things he has accomplished that really stand out, nothing specific comes to mind. Then it dawns on you:

John is good at doing nothing.

John is practiced in the art of not doing something. He bides his time, he hangs out, he lets the situation cook awhile until the stars are cosmically aligned, and purposeful action will have its intended effect.

Oenophiles, I am told, call this the dead zone, that period when the wine really isn’t getting better or getting worse, but is just doing nothing, and the best thing is to leave it corked. Drink no wine before its time, and all that.

Certain tribal elders in Africa know this. Whenever a big, momentous decision faces the clan, the elders go off and sit under a tree together, sometimes for days, where they essentially do nothing. Finally, when they have sat under the tree long enough, someone makes a suggestion, and a decision is quickly reached.

The moral, of course, is that you have to sit under the tree long enough.

Doing nothing is often the best course of action, but how many of us type A personalities can actually put up with it? Take my friend who found out he had prostate cancer. His doctor told him that perhaps the best course to follow was “watchful waiting:” basically do nothing and see what develops. Prostate cancer is slow to metastasize, and it probably won’t kill you until you’re 90, and by then, who cares?

But could he put up with doing nothing? Absolutely not. He had to deal with it now, so he went the surgical route.

A lot of medicine is like this. Docs who have been around awhile and seen it all know that the best piece of advice to patients who come in complaining of weird headaches, back pain, GI problems and such is often to do nothing. Ninety percent of the time, the problem will go away on its own, and if it doesn’t, well, we can deal with it then.

But will patients put up with this? Of course not. They went to all the trouble to see the doc, and by God, he’d better do something, and do it quick.

Doing nothing, by the way, is one sure way to lower health care costs. If physicians and patients would lighten up a little and do less of everything, costs would come down and outcomes would probably be about the same. Fat chance of that ever happening.

Recently I experienced firsthand the power of doing nothing. My organization, which prides itself on doing things and being open to surprise and discovery, convened an impressive group of health plans, employers, hospitals and physicians for purposes of undertaking a quality improvement initiative.

Things were humming right along until we came up with a seven-figure budget that someone had to pay if we were to take the next step. We made a few phone calls, and not many of them were returned.

What should we do? I thought of various options, and none of them seemed right. Then I remembered a lesson from my former life as a professional fund-raiser. It was developing a sense of timing. I had learned the hard way that you can ask too early, and you can ask too late, but, like Goldilocks eating the porridge, you have to develop a taste for when it’s just right to ask for the money.

So, we did nothing. We did nothing for about nine months, in fact. Oh sure, we had phone conferences, we discussed this and that strategy, we told people we were making progress.

Which reminds me: the best strategy of all is often to tell people you’re doing something when in fact you’re doing nothing. I would even venture to say that over half of what we take to be progress in this over-hyped world of ours is just the noise of gums flapping about all the stuff people are doing, when most of them aren’t doing much of anything at all, except talking about the stuff they’re going to do.

But that’s another story altogether.

After months of doing nothing, the participants in the quality improvement initiative stepped up to the financial plate. I have no idea why this happened, but it doesn’t pay to examine some things too closely. I would like to say it was because of our perseverance and brilliant maneuvering, but in truth we just had to sit under the tree together long enough to let the deal percolate.

Now the fun begins. The lawyers are involved, their clocks are running overtime. We’re all jazzed, we’re going to be doing something, and by God, it’s going to change the world.

I’ll have to put the deal in our budget for next year. Where does it all end? I think I’ll stay home tomorrow and just do nothing. It takes practice, you know. Try it sometime.

Feedback? Send it my way: Roger.Hughes@slhi.org.
*The Drift reflects the views of the author, and does not represent the official view of SLHI’s Board of Trustees and staff.