Why is Reform Resisted? some barriers to change


A powerful barrier to change is the thought biases that allow participants to miss the obvious as they go about their daily work. Many practices and processes have resulted from happenstance and serendipity rather than intentional scrutiny, evidence-based analysis, planning, testing and results evaluation. These ISLAGIATT (it seemed like a good idea at the time) procedures become the status quo, the ‘how we do things here' part of local practice and culture.

As unexamined habits ISLAGIATTs produce path dependence which escapes critical thought particularly under time pressures or the weight of local culture, attitudes and precedent. It takes a significant measure of courage to publically question current practices and even more courage (and energy, and patience, and diplomatic skill) to question ISLAGIATTs associated with a trendy fad or belief-du-jour.

Examples abound. Since the 19th century appendectomy has been the standard treatment for acute appendicitis based on the assumption that without surgical intervention the condition progresses to perforation. Upon recent examination, this habit appears to have no foundation in evidence with antibiotic treatment proving to be almost universally effective. Documented cases of voter fraud are very rare bringing into question the elaborate and costly safeguards increasingly put in place to prevent voter fraud and the resulting systematic dismantling of the civil right to vote. The deterrent effect of automatic prison terms has been routinely debunked, yet the practice continues. The presumed relationship between graduating grades and success in following education stages is negligible. Even the core societal promise of middle-class employment following college graduation is proving elusive for large segments of the population.

ISLAGIATTs are like zombies: they stagger on frightening us all into inaction.

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