When
the evidence is there, why don’t we use it? My concern is provoked by
the research of Pfeffer and Sutton (2006) who indicate that only 15% of
medical decisions are evidence-based. This is startling, and probably
worse for management decisions. Pfeffer and Sutton suggest obsolete
knowledge, personal experience, specialist skills, hype, dogma, and
mindless mimicry of top performers. That is not reassuring.
How
can managers be more mindful of research and approach questions and
problems with empirical evidence? The first step is to check the
literature for what is known about the topic. Perhaps little research
exists, or what exists are small studies. That’s okay; it is a start and
at least you know what has been published. Professional associations,
such as MGMA (www.mgma.com), give members access to literature
databases. These are great tools for searching for research studies. Be
careful of mindless chatter in print. If information is just being put
forward without data or theory to support the premise, be cautious. A
claim can be made for anything to be right or true, but evidence speaks
louder than just words. When looking in a literature database, search
for articles that have been “peer reviewed”. This means that the article
and research has been put through a blind review by similar
professionals and found acceptable for the publication. Managers who
look at the literature first will improve their understanding of the
topic before moving forward with changes.
Recently
I was considering the topic of patient recall and the process clinics
use to encourage patients to have follow up or health promotion visits. I
found in the literature many studies on how patients choose their
doctor for the first visit, and a few studies on what makes patients
continue with the doctor after the first visit. So how does recall fit
into this? I’m not sure yet. I think it has to do with continuity, but
also convenience. I will dive into this deeper to see what comes up.
There is definitely room for more studies on this topic. If we
understand how recall is part of the decision making in seeing
physicians we can better plan for processes that support the decision
making. So much to do, so little time.
Pfeffer, J., & Sutton, R. I. (2006). Evidence-based management. Harvard Business
Review, 84(1), 62-74.