Saturday, October 17, 2009

Why strat/plan is more like nursing than doctoring these days or a different defense of listening

Saw a great show on the growing Nursing Crisis on NOW the other night. Now comes at the end of a series of newsweekly shows (Greater Boston, McLaughlin Group, Washington Week) that generally occupies the attention of my media junky family on Friday evening so I'm usually pretty burned out on current events by then, but this show caught my attention.

The segment began by describing how important nurses were--the proportion of well-trained nurses to patients has huge impact on survival rates--and then went on to detail the causes behind the nurse shortage.

While the majority of the show was about the nurse shortage, I'm writing about the first half of the show here because it reminded me once again that the exhausting, repetitive, caring, tedious work of just paying attention--or what we can call listening now that "listening" is a technical term--is often more important than the single, grand deductive insight in achieving a successful and satisfying outcome.

Maybe it’s because I had spent several hours of that day monitoring radian6 feeds and optimizing keywords for a paid search. Or maybe it was because the earlier half of my week was spent listening to franchisees talk about trying to drive traffic to their stores in our challenging times, but the combination of events made me think that the work I do--strategy and brand planning--seems to be shifting from more high-level diagnostic type work (voila, the strategy is X) that we associate with doctoring to the more continuous listening, monitoring, supporting, comforting and adjusting that we associate with nursing.

I don’t think this shift from big top-down thinking to continual ongoing vigilance is unique to our planning/strategy profession. On the contrary, as others have noted, this shift seems to have impacted just about every field in which an expert has to make an important decision with imperfect information. There are many reasons for this new appreciation for careful, ongoing attention, but the most significant ones seem to be:

  • New technologies of measurement have created an overabundance of data: access to an increasing complexity of data in almost all fields makes it harder to make a simple overarching decision with confidence.
  • We suck at making decisions: Those who study the way we make decisions (from cognitive scientists to behavioral economists) have uncovered innumerable “heuristics” or cognitive biases we all use when we make decisions, often without being aware of them.
  • Skepticism about expertise in general: And related to the above, an empowered non-pro population with new access to pro-grade info is growing increasingly dubious about expertise in general. Just this morning the NYT cited a study in the Journal of Consumer research here that showed we find confident amateur reviews more convincing than expert evaluations. (So it's no accident, I think, that our popular culture is suddenly more interested in nurses than doctors.)

And then, reinforcing my developing thoughts on subject was an article/review I read in the NYRB making exactly the same points about the medical profession.

The review- “Diagnosis: What Doctors are Missing” by Jerome Groopman--isn’t an attack on the profession so much as a description of how so many interpretive professions have evolved: from an early optimism that new technology would help produce infallible expertise to a growing recognition that the complexity of these tools and the limits of our brains only increase the need for good old-fashioned human attention and listening (along with a healthy skepticism about our over-confidence) in order to solve complex problems.

Groopman’s biggest gripe is that the economic structure of the profession make it difficult for doctors to spend time doing what doctors most need to do: that is, listen because the system doesn't allow them to charge for it. Or to put it another way: they can't make money when they behave more like nurses.

There’s obviously been a lot of talk about the importance of listening in the marketing profession as well. And I think listening is important too, but not necessarily for reasons most often cited. Among proponents of listening in marketing, the argument generally goes that now that consumers are in control of our brands we have to listen to them in order to serve their needs. They don't want to be told what to think anymore. (TV is dead: the monologue is out, the dialogue is in, etc., etc.) They want to tell us what to think.

I actually don’t think consumers are in control of brands except in a highly relative way, at least so far. (They can choose among options; just as the patient can choose among doctors; if they could they cure themselves they wouldn't be at the doctor in the first place) Nor does evidence suggest that consumers are very good at knowing what they want. So we shouldn’t convince ourselves that giving consumers what they think they want will make them happy for very long.

No, I think listening is so important less because the consumer is always right than because we (like doctors) are so often wrong, especially when we are making lots of complex decisions. In our newly complex media/culture-scape, it's almost impossible to get everything right the first time, or at least get it so right you that you can't make it better in the near future by paying attention to what happens and making adjustments. It's only by listening that we fix our first mistakes fast enough so that we don't kill our own patients and our brands.