One of our favorite case study organizations features a CEO who never talks about purpose and vision, and openly dismisses the importance of strategy. In fact, he says “I think strategy just gets in the way of us doing our job.”
In this thought-provoking episode of the Humanizing Work Show, we examine a counterintuitive approach to leadership. While creating clarity through purpose, vision, and strategy is often crucial, sometimes the best leadership move is to step back.
We explore the case of Buurtzorg, a Dutch home healthcare provider that’s challenging conventional leadership wisdom:
- When traditional purpose, vision, and strategy statements become unnecessary
- How Buurtzorg scaled to 10,000+ employees with minimal management oversight
- The power of intrinsic motivation in highly skilled professionals
- Applying the Theory of Constraints to identify true leadership priorities
Is your organization’s primary constraint really a lack of purpose? Or are there more immediate barriers to success? Join us as we unpack this intriguing case study and discuss insights that could refine your approach to leadership.
This episode offers valuable perspectives for executives, team leads, and anyone interested in organizational dynamics and effective leadership.
🎧 Listen now to gain fresh insights on organizational success drivers.
👉 For more in-depth learning, explore our online Theory of Constraints course and upcoming Humanizing Work Leadership Intensive.
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Episode Transcription
Richard Lawrence
I just heard a goat scream in the background. I don’t know if that’s going to make it through. We get crickets, goats, ducks, there’s a wide variety of screechy birds out here right now. We have a peregrine falcon that has settled in a tree outside our window that screeches all night long
Peter Green
Well, we’ll see if any of those sounds make it into the episode today
Richard
Yah! Live from the farm! It’s the Humanizing Work Show!
Job #1 for leaders is creating clarity.
Who are our customers? What outcomes are we trying to create for them? Why does that work matter? How are we going to make it happen?
In other words, customer segmentation, purpose, vision, and strategy.
Peter
Crafting and communicating purpose and vision are key capabilities we emphasize in all our leadership training. A leader who can’t engage their team in a meaningful purpose and vision will very likely struggle to build a cohesive, aligned group.
However, one of our favorite case study organizations features a CEO who never talks about purpose and vision, and openly dismisses the importance of strategy. In fact, the way he puts it is, “I think strategy just gets in the way of us doing our job.”
Now, this case study organization is a massively successful one. They’ve scaled rapidly, they’ve taken over almost all of the market share in their sector. And we study it because it’s also highly human-centric. It’s a best of both worlds organization–successful and healthy. So the CEO’s disdain for Purpose, Vision, and Strategy seems counterintuitive. It’s a bit of a leadership curveball. It goes against almost all the standard advice, including the advice we typically share! In this episode, we’ll tell you more about this company, including why the typical approach to purpose & strategy don’t make sense for them, and we’ll see what lessons we can learn from their approach.
Richard
Before we get into it, though, a quick reminder that this show is a free resource sponsored by the Humanizing Work company, where we help organizations get better at leadership, product management, and collaboration. Visit the contact page on our website, humanizingwork.com, and schedule a conversation with us if your organization wants to see stronger results in those areas.
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Peter
Ok, Richards, enough teasing. The company we refer to in the intro is called Buurtzorg, which is a home health care provider that was started in the Netherlands in 2006. Buurtzorg’s founder and CEO, Jos de Blok, is a former nurse whose career had progressed into middle management for another healthcare provider. He was frustrated with the layers of bureaucracy and the levels of control over the nurses, and so he decided to leave that company and founded Buurtzorg, which in Dutch translates to neighborhood care.
The core idea of Buurtzorg is that nurses are highly trained professionals who care deeply about doing good work for their patients. They don’t need a lot of layers of management telling them how to do their job. So Buurtzorg was founded with a single team of nurses providing in home health care for a single neighborhood. That team of nurses had complete autonomy to do things like hire, fire, set salaries, determine procedures, decide how much time to spend with a patient, and what follow up to provide.
That first team was successful and they made a profit, and more nurses, similarly frustrated with their current employer’s bureaucracy, wanted to join. So they spun up a second team in a different neighborhood, and provided the same level of autonomy to that team. That process continued, and 18 years later, Buurtzorg has grown to more than 900 neighborhood-based teams, each with 10-12 nurses. Those teams have similar autonomy as that original team. It’s a bit like a franchise model, with the exception that the teams don’t need to “buy in” to Buurtzorg and kick back a large portion of their profits.
Other companies that scale at that rate usually grow large layers of management, processes, and oversight along with the size of the company. But not at Buurtzorg. The “home office” for the company of over 10,000 people is around 100 people, who are helping with things like keeping track of the books, maintaining an intranet, and providing coaching resources for the teams when they need it.
So what benefit would Buurtzorg get from Jos de Blok standing up and trying to rally the nurses with a “our patients matter” purpose or vision statement? What does strategy look like for this kind of organization? It’s no surprise de Blok says it would just get in the way. In fact, research on motivation suggests that any external version of purpose and strategy would likely demotivate, since the nurses are already highly intrinsically motivated.
Instead, the purpose, vision, and strategy of Buurtzorg are all internally focused. Buurtzorg exists to provide an environment that gets out of the way of nurses. That’s their purpose. Their strategy is to offer nurses the opportunity to start a new team in a neighborhood that’s not already being served by another Buurtzorg team. It’s organic, like the way cells divide in our body
Research conducted by Bill Adams and Bob Anderson, creators of the Leadership Circle model, shows that the leadership competency most highly correlated with overall effective leadership is being Purposeful and Visionary. This capability rallies people, helps prioritize, and gives meaning to the work. So we don’t discount it. But Buurtzorg’s nurses didn’t need someone else to rally them. They needed someone like de Blok to say, “My purpose and vision is to create an organization that gets out of the way of nurses and lets them do what they love to do.”
Richard
I think the Theory of Constraints helps explain why de Blok’s approach works.
The Theory of Constraints essentially says, for any given goal of a system, there’s one thing that limits how much of that goal you get, one constraint, and that constraint is where you should focus on improvement. Of course, as you resolve one constraint, another constraint pops up behind that one, so the Theory of Constraints suggests a process of ongoing improvement, resolving one constraint after another.
I think the reason being purposeful and visionary is so highly correlated with effective leadership is that the constraint before all other constraints in most business systems is getting alignment on what the goal of the system even is. Without that, everyone’s pulling in different directions. It’s unclear what to change or improve. Of course, that’s not going to produce good results.
So, if you can enroll everyone in the same purpose and vision, all the downstream improvement and activity is going to be aligned.
Most leaders need to put deliberate effort towards this. Most companies could do any number of different things. And different people in the company are going to have different ideas of what’s important. So, leaders’ number one job is creating clarity and alignment out of that chaos.
At Buurtzorg, though, they get purpose and vision for free. What’s our purpose? What outcome are we trying to create? The health of the people in the neighborhood we serve.
What’s our strategy? Provide the healthcare this particular group of people needs.
How are we doing on that? Well, are the people in our neighborhood getting healthier?
In healthcare, especially local healthcare like this, purpose isn’t usually the constraint. It’s obvious to the people in the system. The constraint is more likely to be related to capability and to systems. Do people have what they need to do the job well? Do systems make it easier or harder to do the right thing? So, Buurtzorg rightly focuses there.
I kind of laugh at the phrase “the exception that proves the rule,” but I think this actually is the perfect case. Buurtzorg can ignore purpose, vision, and strategy, or at least de-emphasize them, not talk about them much, precisely because their context and org structure gets them easy alignment on purpose, vision, and strategy.
Peter
The other example that comes to mind is a meme I saw from a teacher friend. The meme has a photo of a teacher in a classroom looking exasperated, and a caption that reads “When your school superintendent tells you to ‘remember your why…’” It’s the same situation as de Blok and the nurses. In many schools, teachers don’t need to remember their why, they need their administration to get out of their way and let them teach.
Richard
Do you have Buurtzorg-level alignment on purpose, vision, and strategy in your org? Does everyone know why you do what you do, what it’ll look like when you’re successful, and how you’ll make it happen together? If not, and if you’re a leader, building that clarity is your job number one.
Peter
Want some help as you do that? Join our next public leadership series or contact us to talk through the options for customized in-house training for a group of leaders in your org. Visit humanizingwork.com to learn more. Thanks for tuning in to this week’s episode. It’s farm to table service here at the Humanizing Work show.
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