Search
Home
About
Sign Up
Aug 4, 2026
Every Recurring Problem is a System
Every Recurring Problem is a System
00:00
14:58
Transcript
0:01
[gentle music] Welcome to Harvest the Signal. I'm Jodi Lynn Owen.
0:08
I'm a midwife, a systems builder, and someone who's spent most of my career and probably most of my life fascinated by a simple question: Why do smart, caring people keep running into the same problems over and over and over again?
0:24
These field notes are where I think out loud. They are observations gathered from healthcare, history, business, and really just everyday life.
0:32
Sometimes they'll begin with a story, sometimes with a question I just can't stop thinking about, but they'll always be an attempt to separate the signal from the noise.
0:41
On this episode, most of what you hear is simply me reading the published field note aloud.
0:46
I know not everyone has time to sit down and read, so maybe you're driving to work, folding laundry, walking the dog, or like me, I love to take a walk to just untangle my thoughts, and I wanted there to be a way to bring these ideas along with you in the journey of your everyday life.
1:03
But I also wanted to make it worth listening, so at the end of every field note, I'll leave you with one more signal. It's a short reflection that's just for listeners like you.
1:13
I'll keep it under two minutes because I know your time is valuable, but it's a chance for me to share one more idea, one more thought that didn't make it onto the page.
1:22
And let me add one more thing, speaking of one mores, because this is our first recording. This is not meant to be a one-way conversation.
1:30
One of my favorite parts of thinking is discovering where I've missed something or where someone else's experience reveals a pattern I could not see on my own.
1:39
So if today's field note sparks an idea, or if you have a disagreement with something I say, or it reminds you of a recurring problem you've been wrestling with, I would love to hear from you.
1:50
You know, keep it kind, but tell me what you think. I'm super curious. Some of my best thinking has started with somebody else saying, "Hey, I've been noticing that too," or, "That reminds me of this."
2:01
I love to connect those pieces. And if you are someone who enjoys seeing the invisible systems that shape the world around us, I really think you'll feel at home here, and I would love to hear from you.
2:14
So with all that said, welcome to Harvest the Signal. Now, every recurring problem has a story. More often than not, it's the story of a system.
2:25
We might even say every recurring problem is a system until proven otherwise.
2:31
As I was thinking this through, I thought of Florence Nightingale because Florence Nightingale is remembered as the lady with the lamp, but she should also be remembered as the lady who created the chart.
2:45
The lamp has become the symbol of her compassion, and it's the image most of us carry when we think of her, a woman quietly walking through the dark hospital wards bringing comfort one bedside at a time.
2:57
It's so romantic and really lights up my healthcare services side.
3:01
But that chart, the chart that changed history, that started during the Crimean War when the hospitals were overwhelmed and soldiers were dying in staggering numbers, and the accepted explanation for these deaths was simple: War was killing them.
3:19
Nightingale, however, was not convinced. She began collecting data, not because she loved statistics, I don't know if she loved statistics, but because she suspected something everyone else was missing.
3:32
When she plotted the deaths, a startling pattern emerged. Far more soldiers were dying from preventable infectious disease than from battlefield wounds.
3:42
The problem wasn't only the war, it was the system surrounding the war: poor sanitation, contaminated water, overcrowded wards, really broken infrastructure.
3:54
Later, when she laid that pattern out on paper, it did more than organize information. It made the deaths impossible to explain away as tragic but inevitable circumstance.
4:05
And I've thought about that chart for many years, not because I'm fascinated by Victorian medicine, although PS I am a little bit, but because Nightingale demonstrated something that I kept rediscovering in modern organizations.
4:19
So as a midwife, I've always felt a particular affinity, of course, for her story. Midwives are also often remembered for the same qualities people remember in Nightingale: presence, reassurance, steadiness, compassion.
4:35
Those things matter very deeply, and they always will. But many midwives are doing something else at the same time. They're noticing patterns.
4:43
They're asking why the same fears, the same barriers, and the same failures keep repeating and wondering how care could work differently, not only for the woman in front of them, but for every family that comes after her and the systems we all work in.
4:58
And part of that is training. Midwives are taught to think longitudinally. We don't just ask, "How can I help this person right now?" We ask, "What got this family here?
5:09
What did they go through to get to this arrival point in this clinic room? What will matter next week? What happens after the birth? What does this mean for the next pregnancy?
5:19
And what does this reveal about the community?" That's systems thinking embodied, not because anyone taught systems engineering in midwifery school, but because the work itself requires seeing relationships across time.
5:34
Great midwives don't simply care for births. They think about the systems surrounding the birth. I suspect that is true of many professions.
5:43
We tend to celebrate that visible act of care while overlooking the invisible work of redesigning conditions that make better care possible. Recurring problems rarely stay hidden because the evidence is missing.
5:58
They stay hidden because we look at individual events instead of the system producing them.
6:03
Now, I do want to say here off the written record that is in the field notes that midwives cannot produce better living conditions magically.
6:11
We can produce conditions for the care people receive, and we can decide how we show up to provide that care.
6:19
Social drivers of health need to be addressed in care, but midwives, OBs, nurses, community health workers, while we can't always change the circumstances of people's lives, we can show up with a tremendous amount of compassion and an interest in understanding how those circumstances impact their health and how the systems we design to provide healthcare loop into that story.
6:44
It's one big closed-loop system: healthcare, social drivers of health, how we see people, how people feel in our systems. So this is the piece I want to add in. I don't want to move forward without saying that out loud.
6:58
Okay. I was saying recurring problems rarely stay hidden because the evidence is missing, right? They stay hidden because we look at individual events instead of the system producing them.
7:09
So every organization has recurring conversations, the same handoff breakdowns, the same project slips, the same supply is missing, the same meeting somehow has to happen again and again.
7:20
And then eventually somebody says, "We need more accountability," and they start trying to hold it down onto individual people. Well, maybe, but I've come to see there's a better first question.
7:31
If the same problem keeps returning, what system is producing it? Not who, what. And that single shift changed the way I look at leadership.
7:41
For most of my career, I worked alongside extraordinary clinicians and administrators and the kind of people who stay late because they can't leave something unfinished. You know those people.
7:53
You probably are those people. These are the kind who remember the details that no checklist captured, and they hold entire organizations together.
8:03
Often, I was that safety net myself, on call for patients, juggling operations, chasing compliance, playing Whac-A-Mole with problems that seemed unrelated until I stepped back far enough to see that they really weren't.
8:15
So I do know how this feels. And healthcare celebrates those people, and in a way, it should. But over time, I noticed something uncomfortable.
8:25
The same people were rescuing the same kinds of failures across organizations. Different day, different patient, maybe a different building, same rescue. We call them heroes. I wonder why the system keeps requiring one.
8:41
A recurring problem is information. It's made of multiple parts woven together so tightly that we stop seeing them even. It, it isn't automatically a training problem. It isn't proof that someone doesn't care.
8:54
It isn't evidence that people are failing. It's a signal, often the clearest signal you ever receive about the system underneath the work.
9:03
I've started paying attention to one question whenever I talk with an organization and in my own work. What sentence do people say with a shrug? "That's just how we do it." "It's always been that way."
9:15
"You just have to remember." "Mary knows." All of these shrugs fascinate me. They're often where invisible systems are hiding. Systems rarely arrive fully formed. They accrete.
9:27
One workaround survives because Tuesday was busy. Someone builds a spreadsheet, but nobody ever intended to keep it.
9:35
An exception becomes a policy, and five years later, everyone assumes that's how the organization was designed. That's why recurring problems are so deceptive. We experience them one event at a time.
9:50
Systems produce them as patterns. If something happens once, study the event. If it keeps happening, get curious about the system.
9:59
You know, when you board an airplane, you don't just kind of like hope today's crew happens to be extraordinary.
10:05
You're actually trusting and relying on thousands of invisible routines, maintenance schedules, checklists, communication protocols, everything working together in this orchestrated event so that an ordinary flight remains uneventful.
10:20
That's what good infrastructure does. It fades into the background, and we usually notice it only after it fails. Healthcare is no different.
10:29
Organizations that consistently deliver excellent care rarely depend on extraordinary memory or constant heroics. They make the right action easier than the wrong one. Knowledge survives turnover.
10:44
Learning survives vacations. And yes, I hear your eyeballs popping open because we've all had that happen. Good decisions don't depend on one indispensable person. The people are still exceptional.
10:57
They're simply no longer carrying the entire system themselves. So I've adopted a simple rule. Every recurring problem is a system until proven otherwise. Notice what that doesn't say.
11:08
It doesn't say every problem is a system. Sometimes people make mistakes. Sometimes randomness wins. But recurrence changes the burden of proof.
11:19
When the same issue returns, we can stop asking who made the mistake and start asking, what is the system trying to teach us?
11:27
When an organization absorbs one of those problems into its identity, that little shrug, it hardens into a fact, and it starts to sound like a description of reality rather than a choice, and that's the moment learning stops.
11:42
Recurring problems are not accusations, they're invitations. Nightingale didn't stop at the chart, however extraordinary it was. Seeing the pattern was only the first step for her.
11:53
She and the Sanitary Commission went on to change the conditions that kept producing the same outcome. They improved sanitation, cleaned the water, ventilated the wards, and then the death rate fell dramatically.
12:07
That's the part we forget when we picture the lamp. The lamp comforted the person in front of her. The chart revealed the pattern around them. The reforms changed the future for everyone who came after.
12:22
Those are not competing acts of care. They are concentric circles. Compassion at the bedside, compassion through observation, compassion expressed by redesigning the system itself.
12:35
Now, before you go, here's one more signal, and that's your cue that I'm going to add on to this written piece because you took the time to listen today. So I wanna share this.
12:45
When I look back over my career as I was writing this piece, I really can remember dozens of problems that felt completely unrelated at the time: a billing issue, a missing supply, a communication breakdown, a patient who slipped through the cracks.
13:00
Not very often, but even that can happen to all of us. They all looked like separate fires, and it took me a long time to realize I really wasn't looking at dozens of problems.
13:09
I was looking at a handful of systems introducing themselves over and over and over again. Now, once you start seeing the world that way, it's so hard to unsee.
13:22
You begin to notice the recurring meeting, the recurring apology, the recurring workaround, the sentence everyone says with a shrug and points to one person like, "You're gonna have to get that from her."
13:33
Those are not interruptions to the work. They are the work, and that's the perspective I hope we'll explore together in these field notes.
13:41
Sometimes we'll talk about healthcare, sometimes history, sometimes leadership, probably a lot of times business, but underneath all of them is the same question: What is the system trying to teach us?
13:54
If today's field note changed the way you look at even one recurring problem, then we've started exactly where I hoped we would.
14:01
And I would love to be the voice in your ear while you are walking the dog or driving to work. We can explore patterns hiding in plain sight together. So please hit Subscribe, and we'll do it again.
14:13
Connect with me on LinkedIn by my name, Jodi Lynn Owen, or on Threads @harvestthesignal, and let's keep this conversation moving. If this sparked a thought for you, I would love to hear it.
14:25
The question we leave our readers with on this field notes is, what recurring problem have you accepted as inevitable that might actually be a system waiting to be redesigned? I read every reply personally.
14:38
In fact, the next Harvest the Signal may begin with something you've stopped accepting but haven't yet put into words. Until next time, I'm Jodi Lynn Owen, here to harvest the signal.
14:51
[outro jingle]
Harvest the Signal
Listen on
Spotify
Spotify
Recent episodes
No results found
