Until a surprisingly few years ago, the
practice of medicine was based on long-standing traditions and not on any real scientific principles. In fact, it was not until 1993 that genuine science began to guide
the way medical care was applied. That fact may seem astonishing to people who
tend to equate science and medicine.
But science involves making an
observation of something in nature, proposing a hypothesis about what is
observed, and then devising an experiment to prove or disprove one’s hypothesis.
That experiment must then be replicated by other scientists to prove that the
results are valid. The experimental results are known as evidence. For
example, everyone who drops something is accumulating more evidence for Isaac
Newton’s Law of Universal Gravitation. It works the same way in every
laboratory.
The gold standard for testing theories
about medical care is known as the randomized controlled trial, in which a
treatment is given to a group of patients, while a control group does not get the
treatment or receives a placebo. The two groups are then compared to see if
the treatment actually works. This approach yields actual experimental
evidence concerning whether or not a therapy is effective and whether it should
be used or abandoned.
Tests of that sort were not widely
applied to treating patients until the 1990s, when the so-called Cochrane
Collaboration was begun; including 15,000 volunteers from 90 countries who
systematically review published medical literature to sort out which medical
procedures are based on real evidence and which are simply folklore.
In the wake of that development, two
Stanford professors, Jeffrey Pfeffer and Robert Sutton, spearheaded a movement
to apply similar standards to business management. In a seminal article,
titled “Evidence-Based Management,” published in the Harvard Business Review,1Pfeffer and Sutton proclaimed that managers rely on
“obsolete knowledge gained in school, long-standing but never proven
traditions, patterns gleaned from experience, the methods they believe in and
are most skilled in applying, and information from hordes of vendors with
products and services to sell.”
Their article, which boldly called
managers “ignorant,” sent shock...
