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It's Not What You're Thinking: Precision Problem Solving with No Hypothesis
It’s Not What You’re Thinking by Dr. Rick van Pelt addresses the deep-rooted crises in healthcare—escalating costs, persistent safety issues, and the overwhelming burnout of caregivers. In this groundbreaking work, van Pelt introduces "Precision Problem Solving," a fresh, no-hypothesis approach that reveals how entrenched problem-solving methods have failed to transform the healthcare landscape. His methodology rejects conventional thinking and instead focuses on addressing conflict to create safe learning conditions, objective observation, and sustained solutions through comprehensive understanding of core functional problems.
With over thirty years of clinical experience, van Pelt outlines practical solutions for navigating the chaotic intricacies of healthcare. For example, he discusses how misaligned approaches to patient safety have hindered progress and why fragmented management systems continue to exacerbate burnout. He also explores the importance of interprofessional collaboration, offering insights into how healthcare systems can foster empowerment and ownership by eliminating conflict and focusing on comprehensive understanding.
This book offers a much-needed alternative for healthcare leaders, professionals, and administrators seeking to enact lasting, transformative change. It provides a methodology along with tools designed for practical implementation in complex environments where the stakes are high. It’s Not What You’re Thinking is essential reading for anyone ready to challenge the status quo and build a more reliable, sustainable system.
With over thirty years of clinical experience, van Pelt outlines practical solutions for navigating the chaotic intricacies of healthcare. For example, he discusses how misaligned approaches to patient safety have hindered progress and why fragmented management systems continue to exacerbate burnout. He also explores the importance of interprofessional collaboration, offering insights into how healthcare systems can foster empowerment and ownership by eliminating conflict and focusing on comprehensive understanding.
This book offers a much-needed alternative for healthcare leaders, professionals, and administrators seeking to enact lasting, transformative change. It provides a methodology along with tools designed for practical implementation in complex environments where the stakes are high. It’s Not What You’re Thinking is essential reading for anyone ready to challenge the status quo and build a more reliable, sustainable system.
- GenresNonfictionBusiness
253 pages, Kindle Edition
Published April 29, 2025
14 people are currently reading
1627 people want to read
About the author
Rick van Pelt
1 book8 followersDr. Rick van Pelt has over three decades of experience as a board-certified anesthesiologist and leader in healthcare transformation. Throughout his career, he has pioneered innovative approaches to improving clinical performance, quality, and patient safety, working with frontline-empowered teams to redesign healthcare delivery. His expertise spans system-based performance improvement, implementation science, and clinical variation management to improve structure, processes, and outcomes across health systems. He is also a pioneer of peer support integration and creating solutions to the root causes of burnout faced by healthcare providers. Of note is his deep experience and expertise in assisting leading healthcare systems in transforming acute inpatient and perioperative care models into integrated interprofessional services that achieve clinical excellence and elevate the care experience for patients, families and caregivers. Currently serving as the Chief Clinical Transformation Officer at UAB Medicine, Dr. van Pelt is known for facilitating sustained change in complex healthcare environments with his committed clinical transformation team.
Prior to joining UAB Medicine, Dr. van Pelt was an Associate Clinical Principal with The Chartis Group and led numerous performance improvement initiatives with leading US hospital systems in clinical system assessment and redesign; he has supported and led service transformation initiatives in perioperative, acute inpatient care and hospital medicine. Dr. van Pelt has more than 20 years of experience providing advisory services for national and international health systems and is a frequent speaker on quality and patient safety worldwide.
Dr. van Pelt served for five years as the Director for Global Programs at Partners Healthcare International (PHI), the international division for Partners Healthcare System and its founding Harvard affiliated teaching hospitals, Massachusetts General Hospital and Brigham and Women’s Hospital. Dr. van Pelt served on the clinical faculty at Harvard Medical School and worked at the Brigham and Women’s Hospital and served in a variety of clinical and operations leadership roles in other public and private sectors. He has also served as a faculty member at the Institute for Healthcare Improvement (IHI) and The Dartmouth Institute Microsystems Academy (TDIMA).
Dr. van Pelt is a board-certified anesthesiologist. He completed his anesthesia residency and fellowship at the Brigham and Women’s Hospital at Harvard Medical School and holds his medical degree from the University of Massachusetts Medical School. He received his Master of Business Administration from Harvard Business School and Bachelor of Arts, magna cum laude, from Amherst College.
When he is not actively engaged in his clinical transformation role, Dr. van Pelt enjoys spending time with his family, going for long walks with his wife, cycling, kayaking, and traveling the globe, by airplane of course!
Prior to joining UAB Medicine, Dr. van Pelt was an Associate Clinical Principal with The Chartis Group and led numerous performance improvement initiatives with leading US hospital systems in clinical system assessment and redesign; he has supported and led service transformation initiatives in perioperative, acute inpatient care and hospital medicine. Dr. van Pelt has more than 20 years of experience providing advisory services for national and international health systems and is a frequent speaker on quality and patient safety worldwide.
Dr. van Pelt served for five years as the Director for Global Programs at Partners Healthcare International (PHI), the international division for Partners Healthcare System and its founding Harvard affiliated teaching hospitals, Massachusetts General Hospital and Brigham and Women’s Hospital. Dr. van Pelt served on the clinical faculty at Harvard Medical School and worked at the Brigham and Women’s Hospital and served in a variety of clinical and operations leadership roles in other public and private sectors. He has also served as a faculty member at the Institute for Healthcare Improvement (IHI) and The Dartmouth Institute Microsystems Academy (TDIMA).
Dr. van Pelt is a board-certified anesthesiologist. He completed his anesthesia residency and fellowship at the Brigham and Women’s Hospital at Harvard Medical School and holds his medical degree from the University of Massachusetts Medical School. He received his Master of Business Administration from Harvard Business School and Bachelor of Arts, magna cum laude, from Amherst College.
When he is not actively engaged in his clinical transformation role, Dr. van Pelt enjoys spending time with his family, going for long walks with his wife, cycling, kayaking, and traveling the globe, by airplane of course!
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Displaying 1 - 9 of 9 reviews
May 6, 2025
I won this book in a goodreads drawing.
A book somewhat about the health care system. It's also about precession, which is basically being prepared for luck when it comes.
It's amazing to me anyone survives the health care industry.
A book somewhat about the health care system. It's also about precession, which is basically being prepared for luck when it comes.
It's amazing to me anyone survives the health care industry.
May 17, 2025
This book is a refreshing and thought-provoking guide that challenges conventional approaches to problem solving. By advocating for a disciplined, evidence-first process rather than starting with assumptions or hypotheses, van Pelt offers a powerful framework for professionals and leaders seeking clarity in complexity. What sets this book apart is its accessibility and real-world relevance. The writing is clear and engaging, with practical examples that illustrate how ditching the traditional hypothesis-first model can lead to more accurate, bias-free decision-making. Van Pelt draws from decades of consulting experience to show how anyone—from executives to analysts—can learn to diagnose problems precisely and confidently.
My key takeaways:
Evidence Over Assumptions: The book advocates for investigating root causes through structured data gathering rather than beginning with a hypothesis, reducing cognitive bias.
A Clear, Repeatable Method: Van Pelt presents a step-by-step framework for diagnosing complex business problems with precision, improving the quality of both insights and decisions.
Real-World Case Studies: The book includes compelling stories from the author’s consulting experience, making the concepts relatable and immediately applicable in business contexts.
This is a must-read for business leaders, analysts, and problem solvers who want to move beyond intuition and guesswork to arrive at truly effective solutions.
My key takeaways:
Evidence Over Assumptions: The book advocates for investigating root causes through structured data gathering rather than beginning with a hypothesis, reducing cognitive bias.
A Clear, Repeatable Method: Van Pelt presents a step-by-step framework for diagnosing complex business problems with precision, improving the quality of both insights and decisions.
Real-World Case Studies: The book includes compelling stories from the author’s consulting experience, making the concepts relatable and immediately applicable in business contexts.
This is a must-read for business leaders, analysts, and problem solvers who want to move beyond intuition and guesswork to arrive at truly effective solutions.
June 10, 2025
Plan for Collaborative Problem Solving
This is a review of Rick van Pelt’s “It’s Not What You’re Thinking: Precision Problem Solving with No Hypothesis”. I enjoyed reading the first section, which was a mini-biography of how he got where he is and the need for an effective way to solve problems. The next two sections cover how to solve problems. The examples are for hospitals and medical facilities, but the method would apply to other settings. I thought it was well-written and easy to understand. The book has some wonderful charts and diagrams.
He explains that the problem you think you need to solve might not be the actual problem. He points out that first you need to observe to see what is actually happening. The standard procedures are not necessarily what are being done; people may have needed workarounds. So, it is important to know exactly what is being done.
His method is a collaborative problem solving one. I agree with it, but I already had similar perspectives on problem-solving. It did give me more specifics on how to do things.
I received this book for free via Goodreads First Reads.
This is a review of Rick van Pelt’s “It’s Not What You’re Thinking: Precision Problem Solving with No Hypothesis”. I enjoyed reading the first section, which was a mini-biography of how he got where he is and the need for an effective way to solve problems. The next two sections cover how to solve problems. The examples are for hospitals and medical facilities, but the method would apply to other settings. I thought it was well-written and easy to understand. The book has some wonderful charts and diagrams.
He explains that the problem you think you need to solve might not be the actual problem. He points out that first you need to observe to see what is actually happening. The standard procedures are not necessarily what are being done; people may have needed workarounds. So, it is important to know exactly what is being done.
His method is a collaborative problem solving one. I agree with it, but I already had similar perspectives on problem-solving. It did give me more specifics on how to do things.
I received this book for free via Goodreads First Reads.
May 21, 2025
A Fresh Path for Healthcare Leaders...
The bold, unorthodox approach Rick van Pelt's ‘It's Not What You're Thinking’ offers to solve the toughest issues facing healthcare. His Precision Problem-Solving approach questions conventional wisdom and motivates leaders to address conflict and advance group projects. Van Pelt, having decades of expertise, clarifies why conventional methods fail. The book is loaded with practical strategies meant to enable managers negotiate high-stakes systems.
This is a call to action not only a theory. Its interesting and incisive material challenges readers to reevaluate accepted ideas. For healthcare innovation, this is absolutely required reading. Very highly recommended.
The bold, unorthodox approach Rick van Pelt's ‘It's Not What You're Thinking’ offers to solve the toughest issues facing healthcare. His Precision Problem-Solving approach questions conventional wisdom and motivates leaders to address conflict and advance group projects. Van Pelt, having decades of expertise, clarifies why conventional methods fail. The book is loaded with practical strategies meant to enable managers negotiate high-stakes systems.
This is a call to action not only a theory. Its interesting and incisive material challenges readers to reevaluate accepted ideas. For healthcare innovation, this is absolutely required reading. Very highly recommended.
July 2, 2025
There is a crisis in healthcare, and it’s due to many concerning factors. Caregiver burnout and escalating costs are just two of them. However, there is hope. The author of this book has ideas for addressing the deep-seated issues in the American healthcare system, and he has just the skill set and background to do it. He has over 30 years of clinical experience and has seen firsthand what works and what doesn’t.
Any administrator or healthcare professional who is in danger of becoming burned out should read this book. It’s a breath of fresh air and provides workable solutions that can change the status quo in the all-important healthcare niche for the better.
Any administrator or healthcare professional who is in danger of becoming burned out should read this book. It’s a breath of fresh air and provides workable solutions that can change the status quo in the all-important healthcare niche for the better.
July 15, 2025
Excellent!
This book will guide you in addressing the challenges that persist in complex environments, especially in the healthcare sector. Imagine untangling chronic problems such as high costs, safety issues and staff burnout, but with a truly innovative approach.
In my opinion, this book offers a totally new perspective to problem solving, questioning the established and looking for the real roots of difficulties without assuming solutions in advance and presenting a practical methodology to create an environment where learning is safe and solutions are sustained over time.
Highly recommended!
This book will guide you in addressing the challenges that persist in complex environments, especially in the healthcare sector. Imagine untangling chronic problems such as high costs, safety issues and staff burnout, but with a truly innovative approach.
In my opinion, this book offers a totally new perspective to problem solving, questioning the established and looking for the real roots of difficulties without assuming solutions in advance and presenting a practical methodology to create an environment where learning is safe and solutions are sustained over time.
Highly recommended!
April 14, 2025
This book challenges the conventional reliance on hypotheses in problem-solving, proposing a method rooted in direct precision and evidence-based strategies. Its engaging narrative and clear examples make intricate concepts accessible, providing readers with actionable techniques to refine their analytical skills. Ideal for professionals and curious minds alike, this book is a refreshing guide for those seeking to break free from traditional paradigms and unlock new solutions in both personal and professional contexts. A rewarding read for anyone eager to think outside the box!
July 11, 2025
Insightful
For healthcare professionals, administrators, and leaders seeking sustainable, meaningful transformation, this book is not just insightful—it’s essential. It offers not only diagnosis but cure, making it a powerful tool for lasting impact.
For healthcare professionals, administrators, and leaders seeking sustainable, meaningful transformation, this book is not just insightful—it’s essential. It offers not only diagnosis but cure, making it a powerful tool for lasting impact.
February 24, 2025
This book didn’t really fit in well. It has a lot of information which I found useful and a lot of good facts and insights, however overall I was let down. It is more like a journal than a book.
Displaying 1 - 9 of 9 reviews