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Sue Pelletier

Thanks for putting my mind at rest, Jeff!

But I still have to ask, does all this mean that refusing to adopt best practices should be the new best practice? Sorry, I couldn't resist.

Kristi raises a really good point about healthcare and other data-dependent industries, though I think your line of thought may apply even more in those cases.

The buzzword for clinicians these days is “evidence-based medicine”—good doctors are supposed to follow established guidelines based on clinical research findings rather than their own intuition or ad-hoc experimentation.

But if you look at the guidelines regarding hormone replacement therapy, to cite just one example, they're hopelessly outdated, and a physician could actually do harm by following them. By pushing evidence-based medicine (read: established best practices) above all else, medical associations could not just be stifling innovation, but actually encouraging not-great practices. Then again, it does help ward off malpractice suits if you can prove you're following the "best practice"!

I don't know if you caught Atul Gawande's New Yorker article, The Bell Curve (online at http://www.newyorker.com/fact/content/?041206fa_fact), but it's a great read for anyone interested in how best practices play out in the healthcare arena.

Kristi Graves Donovan

I've really enjoyed these posts, and the corresponding comments. As I've thought about this discussion, I've been struggling with how relevant this is to the healthcare industry. One of the challenges I've noticed in the healthcare industry is the overwhelming emphasis on data and benchmarking against other institutions' practices - which obviously leads to discussions of "best practices." Though I agree that focusing on best practices is inhibiting, I don't think there's a way to get away from it in industries where many decisions are made purely based on data. And unfortunately, that philosophy then plays out in the industry's association. How do you get around that?

John Crosby

I'm glad that the conventional wisdom on best practices is being challenged, as I have always had the gut feeling that embracing the notion was the "easy way out" and limited the ability of organizations to innovate. In the work of associations, my guess is that embracing or rejecting the use of best practices with our members is a double-edged sword, as we certainly cannot expect all members to be truly creative and original. But even as I wrote that last sentence, I found myself thinking, "why not?" For now, I think I'll rest on the principle that no person or organization should strive to do what everyone else is doing. But maybe the appropriate use of best practices is to keep them in mind as an alternative, if creativity or original thinking fail us.

Funny thing... my association's magazine has published an article titled, "Why Best Practices Still Matter," by Susan Leandri, managing director of the global best practices unit at Pricewaterhousecoopers. My God! One of the largest accounting and consulting firms in the world has a business unit that focuses on best practices! Run for your lives!!!

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