Christopher Ho Profile picture
Aug 19 14 tweets 5 min read Read on X
This healthcare company has 10,000 nurses with ZERO managers.

Nurses manage million-euro budgets without approval. They hire their own colleagues.

And they're outperforming every competitor by 40% at 1/3 the overhead cost.

The coolest company you've never heard of: Image
In 2006, nurse Jos de Blok watched the community nursing industry fall into bureaucratic hell.

Patients saw 30-40 different caregivers per month. Nurses spent more time filling out forms than helping people.

His solution wasn't to fix management, but to eliminate it entirely. Image
Jos and his wife both quit their secure nursing jobs.

With 5 kids to feed and zero funding, they started Buurtzorg with just 4 nurses.

They didn't have a business plan, investors or managers. They just focused on doing what nurses do best. Image
Within 12 months, they had 10 locations.

By year 3, they had 350 teams.

Today: 950+ autonomous teams across the Netherlands.

Buurtzorg grew from 4 to 10,000 nurses without adding a single middle manager. Image
Their business model is insanely simple:

• Maximum 12 nurses per team
• Each team manages 50-60 neighborhood patients
• Complete autonomy over everything
• No bosses, no oversight or bureaucracy

Teams that rent their own offices within budget don't need approval. Image
They run the entire organization with just 50 back-office staff supporting 10,000 nurses.

The industry average for overheads is 25%.

Buurtzorg's is only 8%.

Their competitors need 3X more administrators because of their bloated management systems. Image
Ernst & Young found:

40% fewer hours of care needed per patient.

35.7% reduction in total care costs.

They provide their customers with higher quality care at a lower cost. Image
So how do 10,000 people coordinate without managers?

They built BuurtzorgWeb. It's an internal social network where any nurse can ask the entire network for help.

Questions get answered in hours by dozens of colleagues. Image
Every team's performance metrics are visible to all 950 teams.

Productivity, costs, patient hours, everything's public.

Underperforming teams feel peer pressure instead of boss pressure.

And it works better than any management system. Image
They have only 21 coaches for all 10,000 nurses.

But those coaches have zero authority.

They can't approve expenses, make decisions or give orders.

They just ask questions to help teams find their own solutions.
Every founder should take notes of Buurtzorg's results:

• 9.1/10 patient satisfaction (highest in Netherlands)
• Named Best Employer 5 times in 8 years
• 4% sick leave (vs 8% industry average)
• 10% turnover (vs 15% industry)

People thrive when you trust them completely. Image
Jos de Blok's philosophy is simple:

"I don't motivate 10,000 employees. They're already motivated.

My job is to remove the obstacles that prevent them from doing great work."

These principles work everywhere. So what if every company ran this way? Image
That's why Athena helps ambitious founders/CEOs gain back their time while scaling their company.

Delegation is the scaling law of entrepreneurship. If you don't understand it early, you'll find it incredibly hard to scale your business.
athena.com/?utm_source=tw…
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More from @Chr1stopherHo

Aug 16
In 1967, 3 astronauts burned alive within 17 seconds.

NASA’s response? Handing 26-year-olds the power to overrule senior executives.

That gamble would save the 1969 moon landing.

Here's how it worked: 🧵 Image
On January 27, 1967, Apollo 1 sat on the launchpad for a routine test.

Inside are 3 astronauts.

The cabin is pumped with 100% pure oxygen to save weight, and the interior is filled with flammable materials.

There's a spark under one of their seats. Image
A fire breaks out and 17 seconds later, they're all dead.

The hatch opened inward. As the fire explodes through the cabin, pressure skyrockets.

The hatch seals shut with thousands of pounds of force.

Ground crews take 5 minutes just to break in.

It was NASA's darkest day yet. Image
Read 13 tweets
Aug 14
In 2021, leaked court documents revealed Valve employees make $1.3M a year.

But they don't have any bosses, managers or a chain of command.

Yet 336 employees generate $5 Billion a year while setting their own salaries.

How they do it is insane: 🧵 Image
In 2012, Valve's employee handbook leaked online.

A 56 page document revealed their philosophy ignored everything about modern business management.

Co-founder Gabe Newell implemented this after 13 years at Microsoft convinced him bureaucracy kills creativity. Image
With just 336 employees, Valve generates more revenue per person than Google, Amazon, or Microsoft.

Their 2021 leaked financials showed:

• Admin staff: $4.5M average salary
• Game developers: $1M average salary
• Total revenue: $6.5 billion

How is this possible? Image
Read 15 tweets
Aug 12
In 1943, Kelly Johnson built America's first fighter jet in 143 days with just 23 engineers in a circus tent.

His management strategy was so radical, it's still considered impossible by MBA programs.

Here's how it worked: 🧵 Image
In 1943, Nazi Germany had fighter jets. America had none.

The military's solution was to form committees, write reports and hold meetings.

But Kelly Johnson's solution was different.

He locked 23 engineers in a rented circus tent with zero oversight and got to work. Image
To make America's first ever jet quickly, Johnson created 14 rules that violated everything corporations believed.

Let's breakdown some of them👇

Rule 1: "The manager must have complete control of his program."

He reported to the division president and nobody else. Image
Read 14 tweets
Jul 2
Nucor - a $40 billion steel company operates with just 70 people at HQ.

Factory workers earn more than their managers, and there have been ZERO layoffs in 60+ years.

How Nucor does this feels unreal, but it isn't 🧵 Image
Producing 25 million tons of steel is no joke.

Nucor produces more steel per employee than any US competitor while having the lowest labor cost per ton.

But how are they doing it despite paying the highest wages in the steel industry?

Let's dive in 👇 Image
But first, take a look at this chart.

The US produces just 5% steel of the global steel production.

On the other hand, China produces 63%.

That's a crazy number... Image
Read 18 tweets
Jun 26
America's 2nd largest private company makes $125B/year, but most people haven't even heard of it.

Its revenue grew 100,000% during its first 40 years and has outperformed the S&P 500 by 26 times.

The company that breaks every rule taught in MBAs 🧵 Image
You use Koch products daily without knowing it.

• That Brawny paper towel? Koch.
• Dixie cups at the office? Koch.
• Stainmaster carpet? Koch.
• The spandex in your workout clothes? Koch.

120,000 employees across 60 countries, hiding in plain sight. Image
While most Fortune 500 companies centralize control, Koch does the opposite.

They built their empire on a counterintuitive principle:

Give maximum freedom to employees at every level of the organization.

No micromanagement and no bureaucratic approval chains. Image
Read 15 tweets
Jun 24
A $5 billion company has operated for 65 years with ZERO managers.

Employees hire their own colleagues, rank each other for compensation, and choose their own projects.

This company has never had a loss-making year since 1958.

Thread Image
W.L. Gore is a material science company with 13,000+ employees holding 1,000+ patents.

Your Gore-Tex jacket, medical implants, and guitar strings? All made by workers who report to no one.

And they have achieved that with ZERO management layers.

The question is how? Image
The foundation of Gore's system is the "Lattice Organization."

Every January, workers don't get assignments—they negotiate commitments with teammates who depend on their work.

These aren't suggestions. They're sacred promises between peers. Image
Read 17 tweets

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