Research & Practice: Commentary: Ari Heller

Ari Heller, MD, MBA. Email to Pfeffer and Sutton on May 13, 2006:

Dear Drs. Pfeffer and Sutton,

During the past week I further reflected on Evidence Based Management (EBMgmt) and its implications on the following issues and topics:

1. The Practice of Management
2. A Clinical Process in the Practice of Management
3. Management as a Profession
4. Program Evaluation of Managerial Interventions
5. Business/Management Education
6. Research in Management
7. PhD Training in Management
8. Basic Sciences in the Business School
9. Clinical Sciences in the Business School
10. Barriers to Change
11. Possible Solutions
12. EBMgmt movement needs a Strategic Plan

I'll try to address these issues and topics

1. The Practice of Management

1.1 To the best of my knowledge there is no agreement on what constitutes best (or correct) management practice. In medicine, some medical specialty groups introduced practice guidelines. Some of the guidelines are evidence based while others are based on the work of a committee.
 
1.2 In management there are multiple theories, gurus, anecdotal evidence and case studies.
 
1.3 There is a lack of an agreed upon Clinical Process in Management Practice.
 
1.4 Question: Where will the SCIENTIFIC EVIDENCE on MANAGEMENT PRACTICES come from ?

2. An agreed upon Clinical Process in the Practice of Management would/could bring some order and structure the thinking process and actions/interventions of managers.

3. Management as a Profession Business Schools are considered a professional school along with Medicine, Law, Nursing, etc.. Yet anyone can become a manager or business person without going to Business School.

3.1 There is the perspective of sociology of professions as it pertains to business/management.
 
3.2 There are no licensing requirements to becoming a manager/business person except for accounting, securities, financial planning and actuaries.
 
3.3 Question: How can EBMgmt strengthen business as a profession with an evidence base and a specialized body of knowledge and skills ?

4. Program Evaluation of Managerial Interventions

4.1 There are methods from the field of Program Evaluation which can be used to evaluate managerial interventions. 
 
4.2 The PROGRAM EVALUATION KIT (Sage Publications) written by Joan Herman, Lynn Lyons Morris and Carol Fitz - Gibbon has nine volumes. The first volume entitled EVALUATORS HANDBOOK provides a good overview.

5. Business/Management Education

5.1 EBMgmt has the potential to transform business education.
 
5.2 Within a School of Business this would require the cooperation of the curriculum committee and senior faculty from each of the fields/areas (e.g., Management, Operations Management, Marketing, Decision Sciences, Finance).
 
5.3 The agency which accredits business schools would also have to take part.

6. Research in Management

6.1 If one looks at the top research journals in the management field (e.g., AMJ, ASQ, Organization Science, Management Science), then one finds that there is not much focus on management practice but rather on theory, theory testing, and theory based empirical research.
 
6.2 Question: How could/would one encourage researchers and scholars to shift their focus to MANAGEMENT PRACTICE and EBMgmt ?

7. PhD Training in Management

7.1 To the best of my knowledge, the focus in the top B-schools is on theory (e.g., economic basis of strategy and management, sociology of organizations,
psychology (Micro-Organizational Behavior) and management theory and empirical methods; with very little focus on MANAGEMENT PRACTICE.
7.2 Question: Is it possible to modify the current PhD training programs and include MANAGEMENT PRACTICE and EBMgmt ?

8. Basic Sciences in the Business School

8.1 Medical Schools are divided into Basic Sciences (e.g., Physiology, Anatomy, Pharmacology, Microbiology, Immunology) and Clinical Sciences (e.g., Surgery,
Pediatrics, Cardiology, Nephrology).
 
8.2 Henry Mintzberg (McGill) posits that the Business Schools are weak in the area of Practice of Management.
 
8.3 Mintzberg's observation could be explained by the fact that there are no CLINICAL (PRACTICE) SCIENCES in the Business School.
  
8.4 The existing disciplines/fields in the Business School could be considered as the Basic Sciences.

9. Clinical Sciences in the Business School

9.1 There is a need to develop the PRACTICE of MANAGEMENT within Business Schools.
 
9.2 This could be done by developing Clinical Sciences within the Business School.
 
9.3 Evidence Based Management is the scientific and methodological basis for the Practice of Management. 9.4 This is analogous to Clinical Epidemiology and Evidence Based Medicine which are the the Basic Science for Clinical Medicine.

10. Barriers to Change

10.1 The students at IESE Business School in Barcelona are correct in pointing out that EBMgmt requires change.
 
10.2 The internal stakeholders within business schools are focused on theory -- especially in the top B-Schools. 
 
10.3 The external stakeholders (e.g.,, business leaders, alumni) may not be aware that they lack a clinical process and practice without an evidence base. They are content with using their intuition and experience as the students at IESE argued. 
 
10.4 COMMENTS: These barriers to change could/should be addressed explicitly in order to demonstrate to the internal and external stakeholders that they are essential to the success of the EBMgmt movement.

11. Possible Solutions

11.1 Identify forward thinking allies within a given Business School.
 
11.2 Bring MDs to B-Schools as faculty members because they have a structured clinical process and could introduce new ways of thinking. This would be analogous to bringing PhDs in Industrial Engineering into Operations Management Departments; PhDs in Psychology and Statistics into Marketing
Depts; PhDs in Sociology into Management Departments, etc.
 
11.3 COMMENTS

11.3.1 Dr. Sutton wrote me that he spoke with a group of Hospital CEOs about EBMgmt and they liked it.

11.3.2 However, business people outside of healthcare may argue that healthcare management and medicine is a special industry. Thus, you may wish to use supporters- practitioners from a variety of industries.

12. EBMgmt movement needs a strategic plan

12.1 The Pffefer & Sutton book on EBMgmt is seminal and has an impact on Theory, Practice, Education and Research.
 
12.2 The idea of creating a EBMgmt movement is great; however the EBMgmt movement needs a strategic plan.
 
12.3 Dr. Sutton mentioned that both of you are creating a website to further disseminate EBMgmt.
 
12.3.1 You may wish to include the strategic plan for the EBMgmt movement in the website.
 
12.4 I think that it is important to include a clinical process in management practice in the website because a well defined clinical process will facilitate the actual practice of EBMgmt."

Best wishes,

Ari Heller, MD, MBA