I Looked for the Devil; He’s Not in the Detail!

Balaji Ramadoss
Edgility
Published in
5 min readJan 5, 2021

…Instead found him in big ideas.

“Think big!” “Let’s double-click on it!” “Create synergy!”

As comical as these management consultant terms might sound, they serve a specific purpose: to sell management consultant services. While these terms generally have a shelf life (no one is double-clicking anymore, as far as I know), “thinking big” has integrated itself as part of our cultural DNA.

Imagine a room full of suited executives, decades ago, saying to their clients, “Let’s think a little bigger!” Sounds exciting and ambitious, like a trip to the moon. The subtext? “Hire us to think big for you because you can’t do it for yourself.”

Today, the dizzying pace of innovation means we live in a world where thinking big has become easy. We got to the moon, and a human on Mars is well within reach. Why not aim for Jupiter next?

Thinking big is easy. How many conference rooms are full of big thinkers who pontificate with fancy slide decks. However, big thinking leads to “30,000 ft” view conversations without knowing what is really on the ground.

Forgetting to think small is what sunk the much-celebrated joint venture of three U.S. giants: Warren Buffett (Berkshire Hathaway), Jeff Bezos (Amazon), and Jamie Dimon (J.P. Morgan). The three had the unparalleled ambition to disrupt healthcare delivery with the creation of their company, Haven. Wall Street was so convinced by their big vision that their 2018 announcement sent healthcare stocks tumbling. After three years of failing to make any meaningful progress, the venture has come to an end. What did them in? The inability to address practical logistics to get the ball rolling. The companies’ needs were too distinct. The problems they faced were too knotty to be unraveled merely by big thoughts.

Successful “innovators” are really detailed thinkers.

Jeff Bezos does not like presentations. Amazon does not use this tool to make ideas visually captivating rather than executable. Instead, all Amazon meetings start with six-page (double-sided!) memos that define, with precision, the details behind whatever big idea someone is pitching.

Elon Musk points fingers at M.B.A.s whose “big” thinking leads them to bury their heads in financial spreadsheets, at the cost of developing excellent products or services.

When we look at figures like Bezos and Musk, it’s clear there’s nothing wrong with dreaming big, but the thinking? It needs to be small — detailed.

The Key Features of Thinking Small

So, what is it about thinking small that is unique? I’ve identified three key features.

  1. Empathize with the detail

There is a Trillion Dollar worth of waste in the U.S. Health-system, making it a noble “big picture” problem for Haven to solve. If anyone can do it, it is Haven. But hidden in plain view are logistical hurdles that fight generalities. Big ideas, obscure expectations, and overly simplify the problems.

It took amazon 20+ years to breakneck innovation to fulfill people’s want to find great products at great prices without leaving the comfort of their home — and without waiting for weeks. Amazon Prime arose to fill that need. But over time, Amazon inevitably had to refine their return process after repackaging an item and printing out a label became too inconvenient. The banking industry offers a great example of empathetic products: the ATM was created to help avoid the inconvenience of waiting to see a bank teller. Today, we have a mobile check deposit that turns your cellphone into a bank branch.

Details create a clear picture of the vision and enable empathetic products, services, and solutions.

2. Design the Details

Design detail gives depth to the “big thinking,” just like the painter’s brushstroke details. Think how an iPhone fits comfortably into the hand. A person can text on the subway or scroll through an article while taking a walk. This attention to detail distinguishes premium brands where big thinking guides very specific, narrow, and detailed deconstruction elements.

3. Orchestrate Details

I like to think about the importance of orchestrating details through the classic game “Go.” Unlike Chess, with 20 possible opening moves, the Go player has 361 possible opening moves. This wide latitude continues throughout the game. At each move, the opposing player is likely to be surprised by their opponent’s move, and hence they must rethink their plan of attack. Self-discipline is a significant factor in success at this game.

In business terms, the ability to orchestrate finer details and options to find the optimal course for success requires competency and self-discipline. To use the example of healthcare, if the objective is to get the patient discharged as safely as possible, the pathways are even more numerous than in “Go.” The ability to break down each patient’s path to recovery directly correlates to eliminating the $1-trillion-dollar waste in the system.

Solution — Iterating on Detail

Just like “slowing down to speed,” developing detail helps achieve the larger goal. To better develop and orchestrate the detail, we recommend creating a management model that can iterate. Specifically, always form two layers of detail, one toward the goal (the broader detail) and another on the execution (the finer detail). In healthcare, this translates to developing a plan for the patient’s immediate care (finer detail, example: pain management) while focusing on the discharge plan (broader detail, example: post-discharge care). Working at two levels allows for cognitive iteration on the detail towards the larger goal — in other words, realizing the big dream — #TheTrillionDollarProblem.

In the shadow of its ambitious “big” brother, thinking small has an unfair reputation of triviality and tedium. For evidence of this cultural misunderstanding, look no further than the expression, “the devil is in the details.” Sure, it takes a great deal of competency to manage all the infinite details that emerge from a given scenario, but that’s the only place I’ve ever found the steps to make big dreams a reality. When I finally did find the devil, he was in the big ideas.

Without details, big ideas are just bumper stickers.

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Balaji Ramadoss
Edgility

Passionately Curious, Founder & CEO @Edgility, Former Stanford Healthcare VP for Technology Experience and CTO Tampa General Hospital