by Sydney Finkelstein
The “paleo diet” is taking the world by storm. A virtual industry of books (Paleo Slow Cooker), magazines (Paleo), and blogs, podcasts, and retreats (Everyday Paleo) have been popularising the idea that eating what cavemen ate — lots of meat, fish, and plants; no grains, sugar, and dairy products — is the path to weight loss and better health.
While the “research” behind these recommendations is subject to considerable dispute, the one thing we do know for sure is that most cavemen died by age 25. It’s true that high infant mortality was a dramatic contributor to this pattern, but the fact remains that few made it anywhere close to the modern day life expectancy of 75 to 80 in western countries.
So, do we really want to eat like people who died when most of us are just finishing the first third of our lives nowadays?
The disconnect between recommendations and results is striking. But it’s not all that uncommon, be it about a diet or about business. In a world seemingly overrun with data, analysis, and experts, what people say we should do and what actually works can be like ships passing in the night.
Limit your egg consumption to two or three per week to cut down on cholesterol? Turns out that “expert” advice was wrong, and eggs are a particularly nutritious and healthy way to start your day, with little impact on blood cholesterol levels.
Cut back on saturated fats and salt? Turns out even this holy grail of health has also been found wanting.
There may be no better example of false assumptions driving mistaken decision-making than the business of health care in the United States. Regions of the country that spend more on health care have more hospital beds and doctors, especially medical specialists. So, more spending is good, right?
Not so fast. It turns out that physicians in higher spending regions actually report more communication problems among caregivers and with patients, as well as greater difficulty obtaining inpatient admissions. Even worse, the mortality rate following heart attacks, colorectal cancer diagnosis and hip fractures was actually higher in regions that spent more.
Why do people fall into this trap? For one thing, humans are lazy. They often seek a simple fix for a complex problem. After all, doesn’t it seem easier to “eat like a caveman” than to carefully monitor their daily diet with what they have in the fridge already?
But for any fixes to be sustainable, we must seek hard evidence. Let’s remember what we’re really trying to accomplish and make sure that whatever we’re buying into, it’s going to help us get there. The Paleo diet sounds intriguing — and parts of it might even be right — but don’t you think it makes sense to see how it actually did in practice? Not what we wish, or assume, it would do, but what it actually did.
Same for health care spending. It sounds like a good idea to have more resources for health care, more hospital beds, more specialists. But it turns out that those things don’t actually produce what we really care about — actual health care outcomes.
Fans of baseball will easily see the connection to Moneyball, the Michael Lewis book that introduced a wide audience to the huge discrepancies between accepted wisdom among baseball scouts and what the data actually said worked. For example, there is no such thing as how a baseball player should look — broad shoulders and a square jaw scored points with baseball scouts — but there are a bunch of specific performance-oriented metrics you can look for to indicate potential.
Of course the practice of management is replete with instances of precisely the same problem. Take interviews. Most managers swear by them, and can’t imagine hiring someone who doesn’t come out strong one-on-one. Sounds sensible, but did you know that traditional interviews are one of the worst ways to predict actual job performance?
Savvy managers know to choreograph an interview so they can assess whether a candidate possesses the specific skills and experiences that are needed to succeed on the job.
I’m often asked to evaluate resumes, and my number one recommendation is to specify what you accomplished, and not what you spent time on. Focusing on outcomes provides would-be employers with the evidence they need about your fit for a job.
It would be nice if the focus on outcomes spread to other walks of life. Don’t tell me that you’ve increased the number of hospital beds; show me evidence that fewer people are dying after being treated at your hospital.
While many health care providers will be kicking and screaming on the way to revealing their actual results, this trend is well underway in the US and will be accelerating as the Affordable Care Act (also known as Obamacare) takes root. If only writers of diet books would be so inclined.
Sydney is a professor of strategy and leadership, and Dean for Executive Education, at the Tuck School of Business at Dartmouth and the author of 16 books, including Why Smart Executives Fail. Follow him on twitter: @sydfinkelstein