I am often astonished by the ability of human beings (myself included!) to form strong opinions and then, in the face of mountains of facts that directly contradict our opinions- to stubbornly maintain them. Let's explore.
These images were created by Alicia Falco. To me they illustrate the ideal- new facts altering and pushing out our existing opinions that have become outdated. After the third image, we would go back to the first, with fresh new opinions about the matter in question. Then, life being what it is:
Rinse and Repeat.
Yet we all see a daily parade of examples of people and groups of people and entire corporations and even, can you believe it, political parties wherein some madcap opinion got formed along the way and now it is unshakeable. The trouble is, these opinions often stand in the way of good communication and progress in the world. They are not harmless.
Diffusion of Innovations is a theory of how, why, and at what rate new ideas and technology spread through social systems; the chief architect of Diffusion theory is Everett Rogers. Diffusion research often unveils surprising resistance to the spread of new ideas that, many years later in retrospect, seem so obviously beneficial that we would have expected almost instantaneous adoption.
Dentistry has a number of examples of surprisingly slow diffusion, and therefore opinions that were not shaken loose by new facts. My favorite involves innovator Dr. Michael Buonocore. He was the first dentist to bond or adhere a restoration to a tooth, in 1955. This was enamel-only adhesion yet was still a major advance. Adhesive restorations have spectacular advantages over any filling material that is only stuffed passively into a tooth. Yet the widespread adoption of adhesive dental restorations took until the late 1970's. Twenty years! Imagine if Microsoft and Apple took this long with new product development and releases...
With the advent of dental adhesion there were still technical hurdles to using bonded composite resin restorations in back teeth. These hurdles involved wear resistance of the materials and also the strength of bond to the insides of teeth (dentin) in the high-stress back-tooth environment. Once again however we find slow adoption of new ideas. In 1985 excellent bonding techniques for dentin were independently developed by Takeo Fusiyama and John Gwinnett. Around this time the wear resistance of the filling materials was dramatically improved as well. Yes, the whole package of a bonded, tooth-colored restoration for use in molar areas was worked out back in the Reagan Era, and yet to this day many practitioners still stand by silver amalgam restorations, an innovation introduced during the presidency of Andrew Jackson. Gack!
Take a minute and have a good, honest look at your own field. See any innovations that took a long time to be adopted? See any that should be introduced, already?
What would cause us humans to be so stubborn about our opinions and beliefs once they are formed? Some would say it's our ego, our dislike of being proved wrong. Losing face; what a strange little expression that is! Yet whenever something fundamental about ourselves needs examining, I turn to thoughts of our evolutionary past, to the forces that formed us. There were likely supreme advantages to being either stubborn in adherence to choices made, or to being highly flexible when presented with new information about the world around us. The middle ground, being wishy-washy, was a dangerous dead zone.
Imagine a tribe of early humans, with no modern knowledge of geography, no GPS, in fact "No phones, no lights, no motor cars", who are faced with a steadily cooling climate and the spectre of glaciers. There would be an advantage to getting the idea in their head, expressed in the language of the times of course, of "Go south! It's warmer there!" Strict absolute adherence to this plan would save the tribe, especially when they saw contradictory evidence, like better weather temporarily behind their backs or a beautiful tempting valley lying off in the wrong direction. Yet what if the tribe had set out to go north instead? Then the advantage goes to the leader who first recognizes, "Hey, we're freezing our flintknappers off here, we gotta turn around RIGHT NOW!" and convinces his flock to turn around in spite of the wasted time and tacit admission of being wrong.
Do you see? Either strategy has a decent chance of success, so we have ended up today with two groups in opposition: people who tend to hold tightly to their opinions no matter what and people who are mentally highly flexible. It's the undecided folks, the ones who prevaricate, who go north, then south, then north by northwest, then camp in the same place for a time, then set out again in a random direction... That's how we lose.
On balance I prefer to live in the mentally flexible category. In today's complex world, great advantages reside there. Put simply, it's oh so nice to be ahead of the curve, and maintaining outdated opinions often keeps us back.
My favorite story of all on this topic was relayed by Everett Rogers in his textbook. The Royal Navy was the most important force that held the British Empire together for centuries; in fact the RN is chiefly responsible for English being the most widely spoken language of commerce and science in the world today. You'd think that such a successful institution as the RN would be highly innovative, constantly tossing their outdated opinions aside like old chewing gum wrappers. Think again...
From, then, Diffusion of Innovations, 5th Edition by Everett M. Rogers:
Scurvy control illustrates how slowly an obviously beneficial innovation spreads. In the early days of long sea voyages, scurvy killed more sailors than did warfare, accidents, and other causes. For instance, of Vasco da Gama’s crew of 160 men who sailed with him around the Cape of Good Hope in 1497, 100 died of scurvy. In 1601, an English sea captain, James Lancaster, conducted an experiment to evaluate the effectiveness of lemon juice in preventing scurvy. Captain Lancaster commanded four ships that sailed from England on a voyage to India. He served three teaspoonfuls of lemon juice every day to the sailors in one of his four ships. These men stayed healthy. The other three ships constituted Lancaster’s “control group,” as their sailors were not given any lemon juice. On the other three ships, by the halfway point in the journey, 110 out of 278 sailors had died from scurvy. So many of these sailors got scurvy that Lancaster had to transfer men from his “treatment” ship in order to staff the three other ships for the remainder of the voyage.
These results were so clear that one would have expected the British Navy to promptly adopt citrus juice for scurvy prevention on all ships. Not until 1747, about 150 years later, did James Lind, a British Navy physician who knew of Lancaster’s results, carry out another experiment on the HMS Salisbury. To each scurvy patient on this ship, Lind prescribed either two oranges and one lemon or one of five other supplements: a half pint of sea water, six spoonfuls of vinegar, a quart of cider, nutmeg, or seventy-five drops of vitriol elixir. The scurvy patients who got the citrus fruits were cured in a few days and were able to help Dr. Lind care for the other patients. Unfortunately, the supply of oranges and lemons was exhausted in six days.
Certainly, with this further solid evidence of the ability of citrus fruits to combat scurvy, one would expect the British Navy to have adopted this innovation for all ship’s crews on long sea voyages. In fact, it did so, but not until 1795, forty-eight years later, when scurvy was immediately wiped out. After only seventy more years, in 1865, the British Board of Trade adopted a similar policy and eradicated scurvy in the merchant marine.
Why were the authorities so slow to adopt the idea of citrus for scurvy prevention? Other, competing remedies for scurvy were also being proposed, and each such cure had its champions. For example, Captain Cook’s reports from his voyages in the Pacific did not provide support for curing scurvy with citrus fruits. Further, Dr. Lind was not a prominent figure in the field of naval medicine, and so his experimental findings did not get much attention. While scurvy prevention was generally resisted for years by the British Navy, other innovations, such as new ships and new guns, were readily accepted. So the Admiralty did not resist all innovations.
265 years to fully adopt a proven life-saving innovation.
And you know what the kicker is? All the other navies and merchant fleets of the world took even longer...