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It is the little details that are vital. Little things make big things happen. -- Coach John Wooden

With March, college basketball shifts into high gear, driving to the pot of gold, aka March Madness. The national tournament captivates even the most casual sports fan. Basketball powerhouses and much smaller schools compete not just for the coveted national championship but for their individual conference championship and a spot in the “big dance.” 
Coach John Wooden and his UCLA Bruins achieved unparalleled success by emphasizing simplicity, consistency and focus on little details. Over a 40-year coaching career, the Wizard of Westwood amassed 885 victories against 203 losses, winning 10 national championships in 12 years. Wooden, himself a former All American guard at Purdue, led the undistinguished UCLA program to conference championships, a Final Four appearance in 1962 and its first national championship in 1964.
Wooden considered himself first a teacher, positioning young men for success. He broke larger or intimidating tasks into fundamental components, believing that success derived from a lot of little things done well. Practice started with three expectations: Be on time, no profanity and never criticize a teammate. He started fall practice with a session on how to put on socks, so his players did not develop blisters. He broke basketball into a game of threes; forward, guard and center; shoot, drive and pass. His frequently quoted, “Be quick but don’t hurry,” references the ability to execute the fundamentals at high speed without conscious thought. No detail was too small.
In his book, “Coach Wooden’s Greatest Secret: The Power of Little Things Done Well,” Pat Williams chronicles not only Wooden’s success but his influence on former players. While some continued into professional basketball careers, most took their lessons learned into everyday life and replayed them for their children. Wooden’s strict repetition and disciplined style did not connect with all of his players, but many recount stories of appreciation many years later. This focus on simplicity and discipline is echoed across larger business organizations, from Disney to IBM. Maybe their leaders played basketball as well.
Some of these same lessons can be applied to medicine. In his book, “Better,” Dr. Atul Gawande describes the complexity of normal labor and delivery -- multiplied by 4 million annual U.S. births -- and Dr. Virginia Apgar’s simple 0-10 scoring method that allowed nurses to rate newborns’ condition at birth. The “Apgar score” is credited with helping to reduce newborn mortality to below 1 in 500, illustrating the value of a simple concept, executed easily and consistently.
In 2003, President Bush presented Coach Wooden with the nation’s highest civilian honor, the Presidential Medal of Freedom. Thirty former players, led by Andre McCarter, wrote letters in support of the award. Wooden was the first person selected for the college basketball Hall of Fame both as a player and a coach. Despite his fame, he remained humble and grateful, genuinely surprised by his recognition. His salary peaked at around $35,000 after winning his 10th national championship, and reportedly he never asked for a raise.  While some of his teams included superstars, many were composed of solid players with a work ethic and sense enough to listen to the coach. His legacy went far beyond the championships. Indeed he had positioned young men for success. 
While I can’t prove a person of good character has more potential as a team player … that is the player I want to coach. -- Coach Wooden
We often miss opportunity because it's dressed in overalls and looks like work. – Thomas A. Edison

Lee M. Duke II, M.D.
Chief Physician Executive
Progress Notes' Editor-in-Chief

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