The Semmelweis Reflex – Don’t Let Fear Defeat What's Right

By Marta Bellamoli, Marketing Co-ordinator at Abacus

The Semmelweis Reflex is a metaphor for our reflex-like tendency to reject new evidence or new knowledge because it contradicts our established norms, beliefs or paradigms. It is named after Ignaz Semmelweis, a 19th century Hungarian obstetrician who found lasting scientific fame, but only posthumously.

Semmelweis discovered that the often-fatal puerperal fever, common among new mothers in hospitals, could essentially be eliminated if doctors simply washed their hands before assisting with childbirth. At the time, it was in fact common for the doctors to perform autopsies in the morning and then spend the rest of their day attending patients in the maternity ward - without ever washing their hands in between. After observing this, Semmelweis speculated that "cadaverous material" could be passed from doctors' hands to patients in maternity wards, causing the disease. He thereupon initiated a strict regimen at his hospital whereby all who assist in a birthing should first wash their hands with a chlorine solution to sanitise them. As a result, death rates plummeted drastically.

Semmelweis expected a revolution in hospital hygiene systems as a consequence of his findings. But it didn't come. Despite the practical demonstration of its effectiveness, his approach was largely ignored, rejected or even ridiculed by the medical community which could not accept they were the primary cause of the childbed fever deaths and that women's lives could be saved simply through better hygiene. In other words, ideology trumped facts. It took another 14 years for Semmelweis' discovery to be accepted when Louis Pasteur showed the presence of Streptococcus in the blood of women with child fever.

This surely is a moving and disturbing story; the tragic sense of lost opportunities and avoidable suffering (and death) verged on the unbearable as I got engrossed in Semmelweis' story. At the end of the day, it is a story about the peril posed by our own behavioural biases and eventually the negative implications of resistance to change.

"That's the way we have always done it" are often cited as the most dangerous words in the language, used as a justification to resist change. Change is hard, as is putting our personal beliefs aside; it would be a mistake to underestimate the challenge of change, and to think that changing either personal behaviours or organisational systems may be a straightforward process. As individuals, we are biologically hard-wired to resist change as we strive to maintain a relatively stable state of equilibrium. As companies, we tend to favour (or even preserve!) the status quo over the change as we see the potential challenge of introducing complex and impactful innovations within our firms.

However, as Semmelweis' vignette demonstrates we should not let our personal behavioural bias - nor our fear of change - prevent us from embracing disruption. To achieve truly great things, we have to explore and test something new. If we don't change things testing and assessing new ideas and solutions, how can we ever make things better?

In order to properly adjust to change, we as individuals and as companies should be mindful of the lessons we can learn from Semmelweis' story.

Evidence over ideology

We all like to think that we make decisions based upon a careful weighing of the evidence; but that is rarely what happens, as the behavioural research now establishes beyond doubt. Our overriding tendency is to concoct belief systems based upon incomplete evidence or even misleading information and then to set out looking for evidence to confirm what we have already decided. Moreover, we are not anything like objective; we interpret the evidence we do examine in ways that tend to be supportive of our prior commitments. We are ideologues through and through.

The key imperative here is to follow the process Semmelweis adopted; he developed a hypothesis first, tested that hypothesis then and, only after the hypothesis was borne out by facts did he act upon it. This full progression is critical. The proper distinction should be clear: is the new idea/process/system backed up by the data or not? If it is, you can proceed. If it isn't, move along elsewhere.

Focusing on what works (now!)

In the hectic, day-to-day business world, relying on a tried-and-true approach is often a harmless, natural course of action; it may be true that the current tactic is working quite well. This is not to say that we should scrap everything and re-start from scratch. However, simply relying on what worked in the past can lead to stagnation as what worked in the past for your company may no longer help your company stay on top of the game right now.

We can honour what came before us, but at the same time we have to be constantly aware of how fast the world is changing. Firms that focus on what works now, and pare away what doesn't, have an excellent chance of surviving and thriving in a rapidly changing business environment. The "winners" are proving agile enough to spot trends and create niches, fuelling demand for new services and products. Instead of short-sighted tinkering around the edges, these companies are changing their value propositions to distinguish themselves from the competition. And instead of relying on tried and trusted approaches, winners are adapting them to push their portfolio of products and services in smarter, more efficient ways.

So now more than ever, let's make a promise to ourselves to keep an open mind to new opportunities and new chances trying to turn massive challenges into meaningful change so to grow as individuals and as companies. After all, that is what change is all about and let's not let it pass us by.


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