THE HISTORICAL CONTEXT OF TOTAL QUALITY MANAGEMENT
by Stuart A. Umpleby
Department of Management Science
The George Washington University
Washington, DC 20052
Umpleby@gwu.edu
September 9, 1993
A keynote address prepared for the
Western Regional Government Total Quality Management Conference
Los Angeles, CA, September 8-10, 1993
THE HISTORICAL CONTEXT OF TOTAL QUALITY MANAGEMENT
by Stuart A. Umpleby
ABSTRACT
The quality movement is a step in the direction of putting management on a
scientific and professional foundation, somewhat similar to what has already happened with
medicine and engineering. All three cases -- medicine, engineering, and management -- have
followed a three stage process. In the first stage an art is learned through apprenticeship. At this
stage fads and quackery are common, because there are no widely accepted procedures or
institutions to test the claims of talented salesmen. In the second stage scientific studies use
controlled experiments to separate what is genuinely valuable from what is merely traditional or
fashionable. In the third stage a profession is characterized by a widely accepted understanding of
fundamentals, a process for generating new knowledge, and continuous improvement in advanced
practice.
INTRODUCTION
Good morning. It is a pleasure to address this group of managers involved directly in the
practice and application of Total Quality Management.
As you heard from my introduction, I am a professor of management science and systems
theory at The George Washington University. Although I have worked on continuous
improvement programs with corporations and government agencies, most of the time I deal with
Total Quality Management in an academic setting. My impression is that the quality movement is
more well-established in business and government than it is within universities, at least on the East
Coast. So I came to this conference in part to learn from you.
You are on the front lines of the movement, trying to put its ideas into practice to improve
the performance of your organizations. I have learned a great deal from you during the sessions
yesterday. Also, the planning and organization of this conference is itself an excellent example of
quality management. This meeting has set a new standard in my mind for how a conference should
be managed.
As participants in the quality movement, you no doubt have encountered people who
believe that TQM is a fad, a passing trend, or just another buzz word. There are those who say that
TQM has had its run and that it is now time for the next movement, perhaps reengineering. If you
are like me, you occasionally wonder whether they are right, and you and I are wrong.
When doubts arise in my mind, I look to the context of the quality movement to get a sense
of perspective. This reflection makes me more certain that those who are advocating TQM are on
the leading edge of important change. When I become discouraged, it helps me to remember that
we are involved in a serious and substantial effort to remake society, that we are not just advocating
2
a particular method that will be seldom discussed a few years in the future. Perhaps an historical
perspective will also give you the confidence and the courage you need to go the extra mile in your
efforts.
Why am I so sure that the ideas underlying TQM are here to stay? Because, based on my
review of the history of other fields, like medicine and engineering, I believe strongly that Total
Quality Management is not just another fad, but, rather, it is the alternative to a series of fads in
management.
THREE STAGES IN THE DEVELOPMENT OF A PROFESSIONAL FIELD
As I read the history of medicine, the history of engineering, and the history of
management, it seems to me that each professional field has passed through three stages in its
development. In the first stage, successful practices are passed down from generation to
generation. An art or craft is learned through apprenticeship, on the job. During the craft stage,
without a mechanism for testing claims, people are often swayed by talented sales persons. Fads
and quackery flourish because there are no widely accepted procedures or institutions to test the
various claims. Only with the beginning of the second stage of scientific testing do people begin to
ask what practices really are effective and what practices are merely traditional. At the third stage
of development, scientific knowledge is incorporated into standard practice.
MEDICINE
Let's look first at medicine.
First Stage
When medicine was a craft, doctors had only a small number of treatments they could
prescribe. Most medical practice consisted of delivering babies, setting broken bones, bandaging
wounds and amputating infected limbs. Before they had an understanding of the causes of disease,
doctors had no choice but merely to treat symptoms.
Second Stage
Science arose during the enlightenment, from about 1650 to 1750, as an alternative to
superstition -- as an alternative to the belief in the Middle Ages in spells, ghosts, and witchcraft.
As science became more well-established, it became more common for claims to be subjected to
experimental tests. However, the results of tests were often disregarded. The story of scurvy and
Vitamin C illustrates the three stages I have just mentioned.
As early as the sixteenth century there were reports that oranges and lemons could prevent
scurvy among sailors. A couple of hundred years later in 1753 James Lind, a British naval surgeon,
published a book showing how scurvy could be eliminated by supplying sailors with lemon juice.
In his book, he cited the case of a scurvy-stricken sailor in 1734 who was in such a bad way that his
3
shipmates marooned him to die. He had almost lost the use of his limbs, but when he was put
ashore he managed to crawl to a clump of grass on which, it was said, he "grazed like a beast of the
field." The herb acted like a charm. In a short time he had fully recovered. (Calder, 1958, p. 23)
Lind performed experiments which proved the value of simple things like mustard cress,
tamarinds, oranges and lemons (in fact, anything, as we now know, which contains Vitamin C). He
was, however, frustrated and remarked, "Some people cannot believe that a disease so fatal and so
dreadful can be cured or prevented by such simple means. They would have more faith in an
elaborate composition dignified with the title of 'a golden elixir.' The people Lind was complaining
about were the Lords of the Admiralty, who ignored his advice for forty years. (Calder, p. 24)
But not everyone ignored Lind's advice. Captain James Cook, on his expedition towards the
South Pole and around the world, followed Lind's advice and took fresh fruit. There was no scurvy
on Cook's ship. Nevertheless, it was not until 18 years after Cook's expedition that the first naval
squadron was supplied with lemon juice for a twenty-three-week voyage and, despite the complete
absence of scurvy, it took another ten years for regulations enforcing consumption of daily rations
of lemon juice to be applied to the entire fleet. Then, and only then, did scurvy disappear from the
British Navy. However, it was only after the lapse of another sixty years that the Board of Trade
applied the same ordinances to all merchant ships. (Calder, p. 24)
So, referring to our three stages, in the early days of medicine people felt more confident of
medicines for which some magical powers were claimed. There was a strong element of wishful
thinking. But gradually over time more and more experiments were made to test various claims.
And, finally, those in positions of authority acted upon the available knowledge.
Tradition and habit are major barriers to new ideas. The battle between art and science can
last for decades, if not centuries. In the nineteenth century the art of medicine and the science of
medicine were in conflict. During the previous century, knowledge of the working of the human
body increased greatly. Organic chemistry, anesthetics, bacteriology, and antiseptics were
developed, and many diseases were identified. The nineteenth century saw the invention of new
instruments such as the stethoscope and, at the end of the century, that great leap forward, X-rays.
There were also major advances in public health, for example the development of sanitation and
those highly important instruments of medical discovery -- vital statistics and epidemiology. The
science of nutrition grew rapidly at the end of the century. And psychology and psychiatry brought
a new approach to mental illness. (Calder, p. 34)
But the nineteenth century was also a time of fantastic fads in medicine. Phrenology, or the
study of character and mental capacity based on the shape of the skull, became the playground of
quacks and charlatans. Patent remedy salesmen hawked the "elixir of life" and cure-alls at carnival
side-shows. A half dozen men living in London at that time had become multimillionaires from the
sale of their patent medicines -- including one, a soothing syrup, which is reputed to have killed
15,000 children a year. (Calder, p. 35)
Doctors rightly deplored the quacks. But their concern with being responsible made them
distrustful of innovations, even when the innovations were scientifically based. A well-known
example is Oliver Wendell Holmes's 1843 conclusion that childbed fever, which he called the
4
"black-death" of mothers, was contagious. He insisted that women about to deliver should not be
attended by physicians who had been handling corpses or other cases of fever. He suggested that
doctors should wash and sterilize their hands. This caused an uproar in a profession which
maintained that doctors, to be respectable, should attend their cases in frock coats and cuffs.
Holmes was right, but at least 10 years passed before the leaders of the profession awoke to these
ideas, and tens of thousands of mothers were sacrificed to tradition, vanity, and stubbornness.
Holmes was relying on observation and common sense. Only later did Pasteur's studies reveal that
germs, or bacteria, were the underlying cause. (Calder p. 35)
So we see that it is not uncommon for evidence to be rejected in favor of custom or
tradition. But adoption of new ideas becomes easier as the scientific foundation of a field becomes
more developed. When people understand the underlying causes or principles involved, it is easier
not only to design remedies or devise solutions but also to win acceptance for them.
Third Stage
The third stage in the development of a professional field is the enforced incorporation of
scientific knowledge into standard operating procedures.
In this third stage, a profession is characterized by 1) a widely accepted understanding of
basic knowledge, 2) the institutionalized testing of innovations accompanied by the reporting of
results, and 3) the design of advanced products and procedures based on current knowledge. In
medicine, we are clearly at the third stage. There is a large amount of accepted knowledge about
the body and the processes of disease. New medicines are subjected to rigorous testing before
being put on the market. And we conduct continuing research to improve products and procedures
to prevent or cure disease.
ENGINEERING
First Stage
The field of engineering is similar to but somewhat different from the field of medicine.
Like medicine, engineering was for most of its history learned through apprenticeship. Instances of
quackery would include claims of perpetual motion machines and early chess-playing computers
that actually contained a midget hidden inside.
Engineering also went through a long process of separating art from science. Indeed it was
not just a matter of separating art from science but of separating magic, science, philosophy, and
religion. In ancient times rulers had their court advisers. These men not only built canals and roads,
but also constructed calendars and advised on administrative and religious matters. In previous
centuries there was less specialization than today. Down to the time of Michelangelo and Leonardo
da Vinci, artists usually were valued more for their skills in military engineering, surveying and
architecture than for their talents in painting and sculpture. (Forbes, pp. 42-43)
5
In the early days of engineering there was occasional inspired innovation, but no research.
A fundamental breakthrough was the idea of standardized components or replaceable parts.
Throughout most of the history of engineering all of the parts of a machine were made at one
location. Today manufacturers routinely buy parts such as screws and bolts from suppliers and
assemble them. But this idea is less than 200 years old. The idea of separating the parts of a
machine came after the idea of separating magic from science, science from philosophy, and
philosophy from religion. Separation or analysis is fundamental to the growth of science.
Second Stage
In engineering there was a gradual replacement of the craftsman by the specialized worker,
a process that was speeded up towards the end of the eighteenth century by the establishment of
numerous technical schools and institutes. During the nineteenth century in France and Germany
workers were systematically given scientific training with a view to providing torch-bearers of the
new technology and care was given to the training of skilled workers. This example was later
followed by the United States. (Forbes, p. 330) Indeed, the idea of a research-oriented university
was imported from Germany.
Third Stage
However, a scientific background for those who would practice engineering was not really
required before World War II. In the early decades of this century well-read, experienced
technicians could design even airplanes without having formal training in science or engineering.
Indeed, many professors in the 1950s still regarded engineering as an art, which was best learned
on the job. Before World War II physics and calculus were electives, not prerequisites. But World
War II brought a fundamental change. The efforts of the scientific community were enlisted in the
war effort, and the results were spectacular -- the atomic bomb, radar, operations research, and
computers. These developments were not merely improvements of previous practice but were
fundamentally new developments. And understanding them required a background in science.
After World War II physics, chemistry, and calculus became the foundation upon which all
of the fields of engineering -- civil, mechanical, electrical, aeronautical, etc. -- were based. Many
schools of engineering changed their names to School of Engineering and Applied Science to
signify the fundamental change in the field.
Returning now to the idea of three stages in the development of a professional field, we see
that after World War II in engineering there was: 1) Agreement on basic knowledge (namely, the
physical sciences); 2) Institutionalized testing of innovations and reporting of results through
research-oriented universities; and 3) The design of advanced products and procedures based on
current scientific knowledge.
MANAGEMENT
So how does management fare in our three-stage scheme?
6
First Stage
At least since the rise of cities roughly ten thousand years ago, people have been practicing
management. But not until the Total Quality Management movement has there been fairly
widespread agreement on what training is important for a manager. Much of the early literature on
management was written by military officers, for example Sun Tzu and Marcus Aurelius. During
the settlement of this country, the leader of a community or a band of pioneers was usually a
minister. Ministers, of course, were trained in theology. Those who managed the government were
usually trained in the law. Not until this century did large organizations feel a need for managers
trained in economics, mathematics, and psychology. Management as a separate academic field
taught in universities is a very recent phenomenon, and its rapid growth has occurred only in the
last two or three decades.
Furthermore, it is not yet universally accepted that training in management is necessary for
success as a manager. Many high level managers today do not have management degrees, and no
doubt a majority of management professors still would insist that management is an art, not a
science.
Second Stage
But many people are trying to take a more scientific approach to management. The success
of Japan in competing with the United States is often cited as a large-scale experiment
demonstrating the value of an emphasis on quality. Additional evidence is that there are many
stories of how companies have improved their operations and improved their positions relative to
competitors by adopting continuous improvement methods.
Furthermore, there is a search for the causes of poor organizational performance, for
example Deming's "deadly diseases." And new products and processes are being designed to
extend basic practice, for example software to assist with quality improvement and the
development of new management methods to address concerns such as second order change or
reengineering.
One of the most hopeful signs, in my view, is the effort to develop an integrated theory of
management. Until recently management has been a collection of approaches or points of view.
However, the importance of developing a general theory of complex, adaptive systems is still not
widely accepted. Nevertheless, TQM has achieved a synthesis of statistics, engineering,
psychology, and philosophy that is practical as well as intellectually stimulating. This intellectual
integration is not a superfluous achievement. Recall in our study of medicine that an understanding
of the biology underlying a procedure made it easier for people to understand its value and to adopt
it. And in engineering an understanding of science permitted the design of completely new
devices.
Third Stage
Although we have not yet completed the second stage of management (that is, an emphasis
on a scientific approach), I believe there are some signs that the elements of the third stage of
7
management are beginning to be put into place. A growing number of companies are requiring all
new employees to learn the methods of quality management. As this conference indicates, there is
now widespread agreement on the fundamentals of management, namely the methods of total
quality management. Also, the continuing review and improvement of the Baldrige Award and the
Presidential Quality Award are one means for institutionalizing the testing of innovations and the
reporting of results. The Federal Quality Institute, the Conference Board, and those who conduct
conferences and seminars on TQM, especially when they apply their methods to their own
operations, both conduct research and report results.
CONCLUSION
What can we learn from these three examples?
Similarities and Differences
In each of the three cases -- medicine, engineering, and management -- there were a number
of similarities. 1) The three stages occur in each case, and the stages overlap in each case. 2) In
each case there was a struggle between the art or craft point of view and the scientific point of
view. 3) In each case there was resistance to new ideas and procedures. 4) Ways of enforcing the
new methods needed to be developed.
There are also some differences between medicine and engineering on the one hand and
management on the other hand. 1) Medicine and engineering have accepted the importance of a
scientific approach. Management has turned to science only recently and incompletely. 2)
Medicine and engineering are based on the natural sciences -- physics, chemistry, and biology.
Management is based on the social sciences, which, not incidentally, are less well-established than
the natural sciences.
Why TQM is an alternative to fads
There are several reasons why I believe that TQM is not just another fad but rather is an
alternative to fads.
1. TQM has a multi-disciplinary scientific foundation. That is, it is not only based on
comparisons and experiments, it is also multifaceted. It is not easily pushed aside by an intriguing
shift of emphasis, for example from an engineering approach to individual psychology, or from
individual psychology to team-building.
2. The Baldrige Award provides a way of doing a management audit. It is a standard
which can be used to compare organizations and which organizations can use to assess themselves
and to monitor their own improvement. The ability to measure performance improvement is very
important.
8
3. TQM is constantly changing to incorporate new findings and new methods. TQM
brings together what is valuable in previous fads. Hence, there is now both an acknowledged set of
fundamentals and an observable state of the art, which is steadily advancing.
4. By focusing on process improvement and empowerment of workers, TQM identifies
what is common to every organization. This is the foundation of a science of management.
5. People can learn TQM by doing it. And TQM provides a common language for sharing
experiences.
In many of the presentations during this conference you have heard and will hear examples
of successful applications of TQM principles in corporations and public agencies. I have pointed to
a few examples from medicine and engineering in order to make the point that what is happening in
management has happened before and that those who are advocates of the quality revolution are
following in the footsteps of pioneers in these other fields.
Of course, I could be wrong. Ultimately time will tell whether Total Quality Management
will be another business flash in the pan or the real thing. But I am confident that it is of great
value. Of course, it is up to all of us to make it happen.
REFERENCES
Calder, Ritchie. Medicine and Man. New American Library, 1958.
De Camp, L. Sprague. The Ancient Engineers. MIT Press, 1960.
Forbes, Robert J. Man the Maker. Abelard-Schuman, Ltd., 1958.
ABOUT THE AUTHOR
Stuart A. Umpleby teaches quality management and systems thinking in the Department of
Management Science, at The George Washington University in Washington, DC. He has received
research grants from the National Science Foundation, the Charles F. Kettering Foundation, the
Open Society Fund, and the American Council of Learned Societies. He has consulted with
government agencies in the U.S. and with major corporations in the U.S., Europe, and Japan.
9
JOKES
Charles T. Munger, Vice Chairman of Berkshire Hathaway, tells of a fishing tackle
manufacturer he knew who made flashy green and purple lures. He asked his friend, "Do fish take
these?"
"Charlie," his friend replied, "I don't sell these lures to fish."
(It pays to know who your customer is.)
Earnie Deavenport, Chairman and CEO of Eastman Chemical, tells the story of a
businesswoman who stopped at a coffee shop and ordered a cup of coffee. The waitress grudgingly
delivered it and asked, "Anything else?"
"Yes," replied the businesswoman. "I would like some sugar, cream, a spoon, a napkin, and
a saucer for the cup."
"Well, aren't you the demanding one," snapped the waitress.
"Look at it from my point of view," said the businesswoman. "You served a cup of coffee
and made five mistakes."
Edward Czapor of General Motors tells the story of a woman who showed up at the gates of
Heaven. St. Peter informed her that, according to his schedule, she was ten years too early and had
to return to earth until her appointed time. She greeted this news with mixed emotions, but since
she was already at the Pearly Gates, she asked if she might have a quick peek at Heaven.
St. Peter said, "Okay," and let her in. She looked around and saw people sitting on clouds,
playing harps. This wasn't exactly her ideal vision of Heaven; it seemed rather boring.
Then she asked if she might take a look at Hell before going back. St. Peter buzzed the
Devil on the intercom, and the woman descended to the nether regions, where she was met by the
Devil. He took her over to a door and let her look.
The scene was magnificent. Before her was a tropical island with warm breezes, people
surfing in the water and dancing on the beaches, all in front of a beautiful sunset.
The woman went back to earth. Sure enough, ten years later she died and found herself
back at the Pearly Gates. St. Peter welcomed her, gave her a golden harp and assigned her to cloud
number 1368, "Just down the third row there to the left."
At this point, the woman asked if she might elect to go to Hell instead of Heaven. While St.
Peter was surprised and disappointed by her request, he nevertheless granted it.
Upon the woman's arrival in Hell, the Devil escorted her to the door and opened it. This
time the scene was very different. There, in full view, was the inferno -- people tied to trees, cries
of anguish, animals biting at their legs, snakes slithering everywhere.
Our friend turned to the Devil and said, "Wait a minute. Ten years ago, when I was here,
this place was an absolute paradise. This is awful now. What happened?"
The Devil replied, "Ten years ago you were a prospect. Today you're a customer."
10