Reviewed 08/2007

In The Tipping Point, Malcolm Gladwell uses a populist approach to understand the elements of change, which have affected the way many have approached our work. In The Wisdom of Crowds, Surowiecki argues that "under the right circumstances, groups are remarkably intelligent, and are often smarter than the smartest people in them." While our culture has traditionally trusted experts, and distrusted the wisdom of the masses, Surowiecki presents compelling evidence and anecdotes to convince us that the collaborative approach has great potential for creating innovative solutions.

In the first part of the book, Surowiecki deals with the theory behind his contention in an eloquent and for me most persuasive manner. While many may question his basic supposition, sighting the many instances of mass hysteria, groupthink, and narrowed focus from group dynamics, he describes the four elements necessary to successful use of crowds (perhaps comparable to our "collaborative" experience in ICSI): 1) Diversity of opinion; 2) Independent decision making at appropriate times; 3) Decentralization of individuals to avoid external influence; 4) Aggregation as opposed to consensus when appropriate. While critics attack him for allegedly ignoring the problems associated with crowds, his book directly confronts both the possible benefits and the potential hazards that need to be considered as we consider the value of the concept.

The second half of the book is replete with incredibly interesting and detailed examples supporting his thesis, which had me turning the pages much like the Harry Potter finale. From discussions of predicting the weight of an ox, counting jelly beans, to Wikipedia, Linux, and stock market issues, he crafts stories which help us identify the linkages to the world of health care in which we work. Even if you're not intensely interested in the concept, the examples as presented will keep your interest throughout.

While not providing specific interventions, I believe this work will be to collaboratives what The Tipping Point has been to change management. As we consider our efforts to move health care to a higher degree of quality, contemplating how to maximize the "wisdom of crowds" without submitting to the influence of the group inappropriately will lead to a more productive conversation and hopefully an improved set of outcomes in the work we lead.