How many placebos do you have in your diary?
Photo credit: Hal Gatewood via Unsplash
In 1955, the researcher Henry K. Beecher published a paper called The Powerful Placebo, which described the placebo effect.
This is the phenomenon that, if you have two groups in a medical trial, and you give one group the drug being tested, and the other group a harmless substitute – a placebo – both groups will show improvement. If you want to know the true effect of the drug, you have to subtract the effect of the placebo.
The causes and mechanisms of the placebo effect have been debated ever since. Some believe that it shows that all physical conditions have a psychological component; some argue that it highlights the challenge of asking people to report the subjective experience of symptoms such as pain; while others claim that it simply shows that if you pay attention to people, they will feel better. Whatever the reasons, it is common practice to adjust for the placebo effect in clinical trials.
I think that we would benefit from looking at the actions we take in the workplace, particularly when we are leaders, and ask whether they have a real effect, or whether they are simply placebos.
The term placebo was used long before Beecher’s trial, and was defined in 1811 as ‘any medicine adapted more to please than to benefit the patient.’ I think that there are plenty of things that we do to please or reassure ourselves rather than because of proven benefit.
Candidates include . . .
The famous meeting which could have been an email, normally detectable when discussion is desultory or missing, when the decisions have already been taken, and the world rolls on as before when the meeting is over.
The progress report, diligently compiled into a set of slides, with traffic lights and charts, risk registers and milestones, which functions as a decorous veil: it gives stakeholders the impression that they project is not so green that it is guaranteed to succeed, and not so red that they should start interfering.
The approvals process, with many steps, many loops and many approvers, where the main goal seems to be to show that the process has been followed, rather than to make the project or product better.
The governance meeting, in which a team of people who are close to the action and know a problem well are summoned to explain themselves to a group of people who are distant from the action and don’t understand the problem at all.
. . . and so on.
In the medical world, placebos are not free, but they cost little to make and do no harm to the patient. In the enterprise world, by contrast, placebos are expensive and can do severe harm to the patient: when an enterprise moves slowly, it is often because of all the placebos its leaders are taking.
However, let us not be cynical. It might serve us well to get rid of all these placebos, but we should recognise that they were probably put in place in good faith, and may even have been effective for a while. But meetings, reports, approvals and governance are all mechanisms that accumulate cruft and debris, rapidly becoming ineffective and ultimately harmful. They need constant work if they are to remain true to their original intent.
Furthermore, we should remember that one of the possible causes of the placebo effect is simply that people feel better when someone pays attention to them. Enrolling in a trial, going to a clinic, speaking to a doctor and receiving some form of treatment may be a great relief to the patient, especially if they have been suffering from a long-term condition and feel that no-one cares.
In the enterprise world, teams are often doing work, solving problems and facing obstacles without knowing whether their leaders, sponsors and stakeholders care what they are doing. Sometimes an email, a report or a meeting may simply serve the purpose of letting people be heard and show their work.
But if that is our intent, we should be explicit about it: let us organise our work to benefit the team rather than please the boss, and make it medicine rather than placebo.
