Saturday, February 6, 2016

The Tale of the Five Monkeys and "The Way We Do Things 'Round Here" Syndrome

I am always amazed at how many times I have asked someone at work why he or she is doing something a particular way and get the response, "That's the way I have always done it."  Social psychologists and management scientists even have a name for this - it's called the "way we do things 'round here" syndrome!  The famous computer scientist and former Navy Admiral, Grace Hopper said, "The most damaging phrase in the language is 'It's always been done that way.'"   Simply put, deeply ingrained cultural habits are some of the hardest things to change or overcome.  The "way we do things 'round here" syndrome is one of the most frequent killers of any change initiative, at any level (individual, unit, department, or organization). 

There was a famous social science experiment performed many years ago - it is one of my most favorite examples of the "way we do things 'round here" syndrome (editorial note: This kind of experiment could never be done nowadays!).  The experiment was set up something like this - five monkeys were placed in a cage.  Scientists placed a bunch of bananas on top of a tall step ladder in the middle of the cage.  Every time a monkey started to climb the ladder, the scientists would spray cold water on the rest of the monkeys with a hose.  After doing this several times, scientists started to observe that whenever one of the monkeys started to climb the ladder, the other four monkeys would drag the monkey off the ladder and beat it up (think of the "code Red"in the movie A Few Good Men starring Demi Moore, Tom Cruise, Kevin Bacon, and Jack Nicholson).  The scientists actually only had to spray the monkeys with cold water a few times.  The monkeys had developed their own version of negative feedback (beating up any monkey that tried to climb the ladder).  After several attempts at climbing the ladder and getting beat up, the monkeys eventually stopped trying to get to the bananas. 

In the next phase of the experiment, scientists removed one monkey from the cage and replaced it with a new monkey (this monkey had never been sprayed with water and had never been beaten by the other monkeys).  The same thing occurred - more beatings by the rest of the monkeys.  Eventually, the new monkey would "learn" and stopped trying to climb the ladder.  Each time that the group of five monkeys reached a point of equilibrium where they refused to climb the ladder, the scientists would substitute one of the old monkeys for a new one.  The same predictable sequence of events followed.  Eventually, all five monkeys had been replaced.  The group of monkeys that were in the cage now had  NEVER been sprayed with water.  Yet, all five monkeys refused to climb the ladder to try to reach the bananas.   It's almost as if the monkeys were saying to each other, "This is the way we do things 'round here!"

There are a lot of nice video animations of this experiment on the Internet - here is one of them (The Five Monkeys Experiment).  The experiment, as told above, didn't actually happen, but is based on a similar study performed in 1967 (The Cultural Acquisition of a Specific Learned Response Among Rhesus Monkeys) by GR Stephenson, as well as several experiments performed with chimpanzees in the 1920's by Wolfgang Kohler.  Whether or not the experiment is fact or fiction is not really important.  What is important is the lesson that it teaches us.  We can all provide examples of times when we don't really know why we are doing something, other than the fact that it's the way we have always done it.  I remember we used to monitor serum potassium in critically ill children admitted to our Pediatric Intensive Care Unit (PICU) with life-threatening, acute asthma.  We used to keep the potassium levels in the blood above a certain level, 3.5  mEq/L (potassium is an electrolyte that is important for your heart to function normally). As it turns out, one of the medications we use to treat these patients called albuterol lowers potassium levels in the blood as one of its side effects.  When we first started using continuously administered albuterol, we were not sure if delivering a lot of this particular medication would cause potentially harmful, low levels of potassium in the bloodstream.  So, in order to prevent that from happening, we followed potassium levels very frequently and replaced potassium whenever it started to get low (note that a level of 3.5 mEq/L is still within the normal range).  After several years of practicing in this fashion, a new physician came to our PICU and challenged this practice.  None of our younger physicians could tell the new physician why we practiced this way other than to say that "this is the way we do things 'round here."  Incidentally, we changed the practice and found out that, while it is still important to monitor potassium levels in the blood for these patients, we do not need to monitor as frequently, nor do we have to be as aggressive about replacing potassium.

The most important idea that I want to convey today is that the "way we do things 'round here" syndrome needs to be recognized.  We will talk more in the weeks to come about how you go about addressing this syndrome.  As the saying goes, "A journey begins with a single step."  Recognizing and acknowledging the problem is that first step...