There have been explicit attempts directly to bring over disciplines from the natural sciences to management through a relatively recent turn to ‘evidence based management’ . One writer, Denise Rousseau, draws on the analogy with medicine as a ‘success story’ in an article advocating for evidence-based management and sums up the key concepts of what evidence-based practice would look like:
- learning about cause-effect connections in professional practices;
- isolating the variations that measurably affect desired outcomes;
- creating a culture of evidence-based decision-making and research participation.
- Using information-sharing communities to reduce overuse, underuse, and misuse of specific practices.
Two other theorists, Pfeffer and Sutton think it is possible to find out unproblematic facts about mergers and acquisitions or management practice, and to apply these facts in one’s own organisation as way of ‘driving up performance’.
What does it mean to be evidence-based as far as management is concerned, and how relevant are analogies made with evidence-based medicine?
In an interesting article following through the implementation of some policy directives on the treatment of glue ear in the National Health Service (NHS), Sue Dopson writes about the way that policy recommendations based on evidence-based medicine were taken up in four NHS hospitals and the surrounding GP surgeries that served them. She found that amongst the different clinical groups who were involved in the treatment of glue ear, GPs, Health Visitors, audiologists, ENT surgeons, there was an acceptance of the recommendations of evidence based medicine in theory (that in this disease, ‘watchful waiting’ is preferable to surgery), but in practice each of the different professional groups had a greater or lesser inclination to follow policy advice. Each of the professionals interviewed by Dopson, whether they followed the new policy or not, rationalised their decisions in their own terms according to how much they trusted their colleagues, the degree to which they felt their professional identity enhanced or diminished by the policy, or how they much they perceived their status to be acknowledged in it. Some professionals were explicit in their recognition of the implied power relations in following, or not following the policy.
Dopson explains the uneven and episodic take-up of the new policy directives by drawing on the figurational process sociology of Norbert Elias (see previous posts). For, Elias the development of societies, the civilising process as he called it, arises from the constantly fluctuating asymmetric power relations between people:
Whether power differentials are large or small, balances of power are
always present wherever there is a functional interdependence between people.
Elias makes the case that we are governed as much by emotion as we are by rationality: both arise together in our relationships with others. He suggested the terms involvement and detachment as a way of overcoming the dualism of objective and subjective and argued that we are more or less both involved and detached at the same time in what we are doing. We approach sets of problems cognitively, but at the same time are caught up in what we are doing as our identities are called into question and our relationships of power with others fluctuate. For Elias it would be impossible to think scientifically about human relating without acknowledging the interweaving of rational and affective selves which arises out of a specific history of interactions, and leads to a further patterning of interactions. He was deeply critical of sociological approaches which talk about social processes as things and describe them as though they were in a reduced and fixed state. Rather, he thought of the relations between people as being in a constant process of flux and change.
Because of the fluctuating power relationships between us as we struggle with each other to implement a particular policy in a particular place, we can expect to make uneven progress. Things will not develop predictably but will be pulled this way and that by the interdependences between people over which no one has overall control. Our relationships with others are formed out of a historical context of relating which set limits around what is and is not possible to do. Looking for context independent variables and cause-effect connections as Rousseau encourages us to find, may prove a fruitless task. To be scientific would be to take account of both rational and irrational in the patterning of human actions.