SIMPLE RULES FOR COMPLEX PROBLEMS: Raymond Rupert MD. MBA. Rupert Case Management Inc.

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According to Donald Sull and Kathleen Eisenhardt in their book “Simple Rules”,  simple rules are shortcut strategies that save time and effort by focusing our attention and simplifying the way we process information.

Simple rules have proven effective in a wide range of activities. Simple rules work because they do three things well.

First they confer flexibility to pursue new opportunities while maintaining some consistency. Second, they produce better decisions. When information is limited and time is short, simple rules make it fast and easy to make sound decisions. Finally, simple rules allow members of a community to work together and synchronize their activities to achieve shared goals.

Simple rules must be limited to a handful. That makes them easy to remember and apply. It maintains a focus that matters. Simple rules are tailored to the person or organization using them. And simple rules apply to a well defined activity.

Simple rules provide a powerful weapon against complexity which often overwhelms individuals. Complexity arises whenever a system has multiple interdependent parts.

Warren Weaver pioneered the study of complexity. In 1948, Weaver described three types of problems: simple, uncertain and complex. Simple problems address a few variables and can be reduced to a formula such as force= mass X acceleration.  Uncertain problems can be addressed with probability theory and statistical analysis.  Weave pointed out that most simple and uncertain problems have been solved and that complex problems are our greatest challenge.

People often attempt to address complex problems with complex solutions. The Glass-Steagall Act a law passed during the Depression was 37 pages in length. It was replaced by the Dodd-Frank Act which is over 30,000 pages in length. It is a complex solution.

Meeting complexity with complexity can create more confusion than it resolves.  People feel overwhelmed with complicated solutions. They stop following the rules.

Simple rules provide a new approach to complex problems. Simple rules maintain a strict focus on what matters most while remaining easy to remember and use. Simple rules focus on the key variables and limit focus on less important peripheral issues. When focusing on too many variables, peripheral variables are often over-emphasized and faulty decisions can be made.  Simple rules can guide choice but also leave ample room to exercise judgement and creativity.

An example of simple rules come from Michael Pollan, a University of California professor and author. He has three simple rules for food. “Eat food. Not too much. Mostly plants.”

Simple rules provide limited guidance. Simple rules are most effective when they apply to critical activities or decisions that represent bottlenecks to accomplishing an important goal.


When dealing with patients with complex problems within a complex system, there are many moving parts.

Simple rules that focus care providers on the most critical variables can be a life saver for these patients.