Why Most Organizations Get Sick (and Keep Treating the Wrong Symptoms)

And sometimes those answers land harder than expected.

A disease

During last year’s Fall cohort, someone asked Jos de Blok (founder of Buurtzorg) about targets.

His response was immediate and unapologetic:

"We never think in targets. It’s a disease to think in targets.

You should think in purpose. Be compassionate about people.

Targets are a stupid idea."

A disease.

That framing stuck with me.

Not just because it was provocative, but because it felt uncomfortably accurate.

And because the moment Jos said it, you could almost hear the room collectively thinking:

Wait… have we built our entire organizations around this?

Yes. Organizations get sick

Jos’ comment reminded me of a fascinating book I read some time ago:

​Zen and the Art of Organizing​ by Dr. Steve Morlidge.

In it, he describes a series of organizational “diseases” that quietly spread through companies, often without anyone noticing.

They are so common that most leaders assume they are just “how things are done.”

But they are not. They are symptoms of deeper structural problems.

And once you see them, you can’t unsee them. You begin to recognize that the organization itself may be unwell.

Mordlige puts it sharply:

"If you mess up your structure or ignore your coordination mechanisms, your company will behave like a drunk person trying to do yoga.

They will become unstable, unpredictable, and absolutely convinced the problem is someone else."

Below are four of the most common corporate diseases he describes.

If you work in a traditional company, feel free to play Corporate Bingo.

1. Budgetitis

Budgeting is the ancient management ritual where intelligent adults gather in fluorescent-lit rooms to pretend they can predict the future.

Budgets are meant to create “control.” In practice, they often create something else entirely:

• Cycles that becomes more important than common sense
• Bureaucracy that steadily expands
• A culture where people defend numbers instead of serving customers

And what happens when the budgeting cycle becomes too rigid?

Frontline teams begin bending rules to serve reality. Managers respond by tightening control. The frontline adapts again, bending the rules a bit more. Managers respond with even tighter control. And so forth.

Congratulations. You’ve created a self-reinforcing bureaucracy spiral.

2. Pathological autopoiesis

This is what happens when one part of the organization begins to act like a rogue organism: it starts serving its own interests rather than the whole.

You might recognize it as:

• The empire-building HQ department
• The factory that “does things its own way”
• The team convinced it is the company

Over time, this part of the system becomes self-reproducing and self-protecting.

It develops its own logic, its own priorities, and its own internal justifications.

Even worse, it remains convinced it is adding value while quietly draining energy from the broader organization.

3. Restructuringitis

This is the classic corporate placebo.

When performance declines, the reflex is immediate: restructure!

Move some boxes on the org chart. Replace some names. Add a layer. Remove a layer. And if needed, add the layer again.

Rarely does anyone pause to question whether the deeper structure itself might be fundamentally outdated.

The result is predictable: the chart looks different, but behavior remains largely the same.

Nothing fundamentally changes.

4. Acquisitionitis

When leaders feel unable to fix internal problems, another strategy often appears: they go shopping.

The logic is seductive. Buy a company that seems to have solved what you have not. Absorb its culture. Import its energy. Announce a new chapter in a well-crafted press release.

Except it rarely works.

Most cultural transplants get rejected quickly.

Simply because the acquiring company’s culture acts like an immune system. Anything unfamiliar is treated with suspicion.

New and innovative practices are gradually reshaped to fit old habits, until little of the original magic remains.

What was meant to inject vitality often ends up being quietly neutralized.

So what's the real diagnosis?

Here’s the uncomfortable truth:

Most organizational illnesses stem from broken systems, not broken people.

They are not caused by laziness, lack of talent, or insufficient motivational speeches about “excellence.”

They arise from poorly designed systems that quietly shape behavior over time.

And only by addressing, and redesigning, those systems can you build a truly healthy organization.

Be the doctor, not the patient

If you want healthier organizations, stop treating symptoms and start fixing the system itself.

And if you’d like to learn how to do that in practice, our next cohort of the ​Progressive Organizational Design Masterclass​kicks off in April.

It’s where professionals learn how to diagnose structural problems and remove these diseases at their root, not simply manage them.

Or, of course, you can keep refining the budget cycle.

Your choice.