Evidential Thinking

In 1915 at a meeting of a Boston medical society, Dr. Ernest Codman unfurled an enormous cartoon poking fun at various dignitaries.

As a result he was suspended from the society and lost his Harvard University teaching post.

His actions didn’t look too clever.

But his cartoon did create a buzz because it brought his big idea concerning evidence based medicine, to a much wider audience.

Codman had developed something called the End Results System.

He thought that hospitals should record ailments of incoming patients, how they were treated and most importantly the end result of each case.

He also advocated that the results should compiled and statistics released, so that people could choose hospitals on the basis of good evidence. Hospitals could then respond by hiring and promoting doctors on the same basis.

It was this that unsettled the medical establishment.

Because doctors would get measured on results rather than their reputation.

(And they knew that reputation is a soft power.)

It was seen as a threat and there was a lot of resistance.

But Codman didn’t give up and over time a growing number of hospitals implemented his scheme.

And then everyone wanted to listen to him, and he was appointed chairman of the American College of Surgeons.

His core insight about the importance of measurements won through.

And it has since been adopted in numerous other fields – especially sport and politics.

Evidence is better than affirmation.