Physicians using evidence-based decision making are committed to identifying, disseminating, and applying the latest research that is soundly conducted and clinically relevant. While this makes common sense, it is not common practice.



Thousands of studies of medical practice are conducted each year. You may find the research findings disturbing. Only 15% of medical decisions are evidence based!

What do physicians rely on the other 85% of the time? It appears to be a combination of the following:

- generally accepted, but never proven, tradition

- methods in which they are most skilled

- information from vendors of products and services

- obsolete knowledge acquired in medical school

Pfeffer and Sutton believe, “managers are actually much more ignorant than doctors about which prescriptions are reliable—and less eager to find out.” A harsh accusation, but one containing a serious reason for concern.

I should point out that Pfeffer and Sutton's research focuses on “how companies ought to be managed” (their own words). Their prescriptive, rather than descriptive, conclusions often clash with the reality of real-world business decision making. Nevertheless, their work reveals opportunities for improving our decision making effectiveness.

As I stated in my book, “Strategic Organizational Learning,” competence in any profession (medicine, management, or consulting) depends largely on the tacit knowledge gained from experience. While I am an advocate for seeking real-world professional experience, our experience will always be limited.

Pfeffer and Sutton, correctly state, “Seasoned practitioners sometimes neglect to seek out new evidence because they trust their own clinical experience more than they trust research.” They go on to say, “information acquired firsthand often feels richer and closer to real knowledge than do words and data in a journal article.”

So, what am I suggesting? Should you discount the hard-earned tacit knowledge you have acquired over many years of professional work? Of course not. But, I do recommend that you become any active member of a community of practice, read the journals in your field, and always question what you “know.”

To read more about this topic, I recommend Pfeffer and Sutton's new book, “Hard Facts, Dangerous Half-Truths, and Total Nonsense: Profiting from Evidence-Based Management” (Harvard Business School Press).