I went to the doctors this week. Well more precisely I went to see one of the staff nurses at the doctor’s practice. I had received a letter telling me that the UK government were offering free health checks for all citizens over 45 years old. And this was my opportunity.
It was all quite straightforward – a questionnaire, blood pressure, BMI, and cholesterol. I passed. My only real issue is that I am older than I used to be and am therefore at increased risk. There doesn’t seem to be a lot I can do about that!
Whilst we were waiting for my cholesterol read to appear on the screen, I asked the nurse how much more Lipitor was being prescribed now it was off patent (and yes I had mentioned that I worked in pharmaceuticals). “None”, was the surprising answer. I had predicted that with increased competition, use would have sky-rocketed. “So why not” was my follow on question?
“Our doctors are much more cautious”, was the reply, “they always want to avoid doing any harm”. I assumed that this was reference to the Hippocratic Oath – Do No Harm – but decided two questions in the one session was my quota, so left, proudly clutching my health report.
This philosophy of ‘Do No Harm’ struck me as being quite prevalent and not just in UK medicine. Many companies introduce new strategies with an implicit, or sometimes explicit, strap line of ‘Do no Harm’. And this makes sense. Doing Harm is never a good plan. Do no Harm, then, sounds positive. In truth, though, and to be more exact – ‘Do no Harm’ does not sound bad.
And this made me think a little more. I came to the conclusion that we could define – broadly speaking – three philosophies for any action or strategy. Do Harm (negative). Do no Harm (neutral), or Do Good (positive).
To apply the ‘Do no Harm’ philosophy in any situation seems – at best – a significant handicap. The simplest way to Do No Harm is to do nothing. But to do nothing assumes that the current course of action is working well and is guaranteed to succeed. So to change strategy, or introduce new activities, we first of all need to accept that our current approach is not working, or will not succeed optimally. Change is therefore necessary.
So back to the Hippocratic Oath. A medic friend of mine explained to me over dinner later in the week that the literal translation is First, Do no Harm. This really helped me. First, Do no Harm implies to me that there should always be a Second action – Do Good. In almost any situation there has to be a viable option for a better, or more successful, approach – To do Good. For example, although its good news that my cholesterol is low, how much better would it be if my cholesterol was 10 fold lower?
In our work, I am happy that our projects or strategies start with a philosophy of ‘Doing no Harm’, but I would prefer a philosophy that we can and will do better. I don’t know anyone who sets off with the intent of ‘doing harm’. But we shouldn’t ever accept ‘Doing no Harm’ as enough. There are always ways and means to do better. It may not always be obvious and it may often be difficult but it is always possible to Do Good.
And we each and every one of us has a support role to play. Do Good requires empowerment and confidence; Do Good benefits from praise and encouragement. Blame will only ever Do Harm.