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The Semmelweis Myth And Why It’s Not Really True

2018 July 8
by Greg Satell

I was serving on an expert panel at a recent innovation conference and an attendee asked about the Semmelweis effect, the tendency for people to reject new evidence that contradicts established beliefs. He wanted to know how aspiring innovators can overcome inherent bias against new ideas.`

The effect gets its name from the story of Ignaz Semmelweis, the Hungarian doctor who pioneered hand washing to prevent infections in hospitals during the 1840s. However, he was unable to get the medical establishment to accept his idea and thousands, if not millions, died unnecessarily because of it.

The Semmelweis effect is very real. We do get trapped in existing paradigms and that often blinds us to important new information. The Semmelweis story, however, is considerably more nuanced than most people give it credit for. The truth is that much of the blame falls on Semmelweis himself. The real story shows how we can overcome resistance to new ideas.

The Tragic Tale Of Ignaz Semmelweis

In the 1840’s, Semmelweis was a doctor at the obstetric ward of Vienna General Hospital. Appalled by the number of deaths from childbed fever, he set out to find a solution and quickly noticed an interesting fact. The death rates in the hospital’s second clinic, staffed with midwives, was significantly lower than in the first, staffed by medical students.

His key insight came when his friend, Jakob Kolletschka, was pricked with a scalpel during an autopsy and soon came down with symptoms much like the women in the maternity ward. Semmelweis inferred that they medical students must be transferring “cadaverous particles” to patients and instituted a strict regime of hand washing. Mortality rates fell dramatically.

Yet instead of being lauded for his accomplishment, Semmelweis soon found himself castigated and considered a quack. Part of the problem was that Semmelweis’s ideas about hand washing conflicted with the prevailing miasma theory of the day. It was widely thought at the time that “bad airs”, not bacteria, caused disease. So hand washing simply didn’t make any sense to the medical profession at the time.

Frustrated, Semmelweis wrote angry letters to prominent physicians and that, as well as political events at the time, led to his dismissal from the hospital. His mental state steadily declined and he was eventually confined to a medical institution, where he died, in morbid irony, from an infection he contracted under care.

What Really Happened

The basic facts of the Semmelweis story are true. He did, in fact, discover that hand washing can prevent infections in hospitals. The medical establishment, for its part, was not as receptive to his findings as it should have been, largely because of its commitment to the miasma theory. Old paradigms can be stubborn.

However, as Sherwin Nuland explains in The Doctor’s Plague, there’s more to the story than first meets the eye. Semmelweis, thinking his results were enough, didn’t see the value in communicating his work effectively, formatting his publications clearly or even collecting data in a manner that would gain his ideas greater acceptance.

Luckily, those that came later, like Louis Pasteur, Joseph Lister and Robert Koch were more attentive and helped establish the germ theory of disease. The truth is that ideas alone, even breakthrough ideas, rarely amount to much. Innovations need to be communicated effectively if they are to spread and make an impact on society.

I’ve studied hundreds of innovators. Each and every one encountered resistance. The ones that succeeded were not necessarily smarter or more talented than the others, but learned to overcome obstacles they found in their path. In the end, that’s what really makes the difference.

A Modern Day Semmelweis

Jim Allison spent most of his life as a fairly ordinary bench scientist and that’s all he really wanted to be. He told me once that he “just liked figuring things out” and by doing so, he gained some level of prominence in the field of immunology, making discoveries that were primarily of interest to other immunologists.

His path diverged when he began to research the ability of our immune system to fight cancer. Using a novel approach, he was able to show amazing results in mice. “The tumors just melted away,” he told me. Excited, he practical ran to tell pharmaceutical companies about his idea and get them to invest in his research.

Unfortunately, much like in the case of Semmelweis, they were not impressed. The problem wasn’t that they didn’t understand Jim’s idea, but that they had already invested — and lost — billions of dollars on similar ideas. Hundreds of trials had been undertaken on immunological approaches to cancer and there hadn’t been one real success.

Nonetheless, Jim persevered. He collected more data, pounded the pavement and made his case. It took three years, but he eventually got a small biotech company to invest in his idea and cancer immunotherapy is now considered to be a miracle cure. Tens of thousands of people are alive today because Jim had the courage and perseverance to stick it out.

Innovators Must Hold Themselves Accountable

By far the most common thing I hear from executives around the world is that they feel that no one is willing to listen to their ideas. Yes, that’s frustrating, but it’s also part of life. People don’t give as much attention to our ideas as we would like because they are busy doing other things, like pursuing their own ideas.

Even after Jim’s idea was accepted, successfully navigated clinical trials and was approved by the FDA, he found that there were still significant obstacles in his path. As it turned out, the treatment was effective in less than 30% of patients. However, others had ideas that Jim could use to improve results. He readily adopted them and today, at the age of 68, he still goes to his lab every day, collaborating with scientists around the world to save lives.

To create a real impact on the world is no simple thing. Innovation is never a single event, but a process of discovery, engineering and transformation and those things rarely happen in the same place. That’s why effective innovators are great collaborators, they get their ideas accepted by adopting the ideas of others and combining them with their own to make a real difference.

Things that change the world always arrive out of context, for the simple reason that the world hasn’t changed yet. That’s why innovation needs communication, because the world is a busy place, with lots of things demanding attention. We can’t expect it to stop simply because we feel we have something to say.

The truth is that we need more Jim Allisons and fewer Ignaz Semmelweises. Innovation takes more than having ideas and expecting others to immediately accept them. If your idea is important enough, then it is your job to take responsibility for it and see it through.

– Greg


An earlier version of this article first appeared in

Image: Wikimedia Commons

9 Responses leave one →
  1. July 8, 2018

    Almost funny. I have a new idea and maybe I see less than enthusiastic acceptance.
    Of course, my idea touches on moral instincts, something that is not only naturally quite resistant to change but also almost impossible to express in words.
    If you do express morality in words, it shuts down the deeper instinctual parts of your brain where moral instincts operate. Sort of if your “verbal” and “non-verbal sides of your brain were incompatible… which they sort of are, only more so in this case. (In conversation, it is easy to communicate though.)
    The parent topics are biology and genetics, topics not widely studied actually and of seemingly limited economic value, especially compared to the electronic-based sciences creating great fortunes these days.
    What I have also noticed though, if you say you have a good idea to solve a problem for someone or a group, they don’t want it, whether articles on scuba or genetics or human development. It doesn’t matter what the idea is, because they have their own ideas they are trying to sell.
    Well, remember Moby Dick, published and popular long after the author was pushing daisies? I’m just hoping that when the disaster becomes obvious, someone will recall I wrote a solution. Or maybe I can convince some grad student to compile and analyze the genetic data. I know the data exists and there is enough to prove that part of my theory I beat them to the idea of de novo mutations by about 30 years or so, but called them non-integral genes.
    One must have a hobby…

  2. Lacey Johnson permalink
    July 13, 2018

    The entire article is worth a read based on one salient statement, “The truth is that ideas alone, even breakthrough ideas, rarely amount to much. Innovations need to be communicated effectively if they are to spread and make an impact on society.” This could not be more true!

  3. July 13, 2018

    Thanks Lacey!

    – Greg

  4. October 10, 2019

    Yeah…Find a breakthrough method which prevents deathes of pregnant women and new-bornes, get fired, abused, announced being false-scientist, watch women and babies keep dying, be forcefully locked in kuku-house (amd finally killed there by animals which believe they are medical workers) and….. try to keep smiling and effectively communicate your ideas to stupid arrogant killers. :). Sorry. Being a current time victim of Semmelweis effect after I found breakthrough method for cancer cure, proved it by all available scientific methods being certified PhD from one of the best universities in the world and doing research in one of top-10 cancer research institutes, got bullied and fired as the result, forbidden to present, forbidden even to submit publication, spent 6 months fighting on different levels just not to let my “professor” to throw all data to the trashbin, I have rights to say – trust me, it is hardly managable not to become reasonably aggressive after that and keep communicating at all. Instead of blaming Ignaz Semmelweis for not communicating well enough, we’d better took measures to prevent replicates of his story in 21st century. My experience shows that Semmelweis effect is real independently on how hard you try to communicate with narcissic power-abusers, cowards and idiots.

  5. October 10, 2019

    Thanks for sharing Ana.


  6. Richard permalink
    April 6, 2020

    @Ana, having spent way too much time in academia as a researcher myself, I can only sympathize.

    Must say that I’m also more than a little intrigued about your, “breakthrough method for cancer cure”. Any hints/sources?

  7. April 6, 2020

    @Richard, due to Semmelweis effect I am not able to share with you the publication as it is blocked by supervisor and the university management is escaping from any responsibility. So everything is stuck. However the truth is obvious and first was highlighted by Otto Warburg, implemented by Johanna Budwig (just curious why I can’t find any of her original publications…) and might be others whom I don’t know. Even with GCMS, LCMS, RNA-sequencing, mechanism explanation, experimental proves on animals I still ended up with the work to be blocked. I can summarize it in few words “Tumor cell and somatic cell eat differently. Biochemicals crucial for survival of somatic cell can be toxic for tumor cell due to the difference in consumption (cellular membrane proteins) and following metabolism”. Find the biochemicals, find the difference in their interaction with the cells, adjust diagnostics, increase concentration of the biochemicals in blood through diet or IV anf the tumor cells will be dying while somatic will be doing ok.
    I found 1 biochemical for liver cancer, explained mechanism, proved. 14 others had phenotype (either suppress or enhance cancer cells growth) but I didn’t have time to find the mechanism of action and design the diagnostic and treatment protocols accordingly.
    Non-toxic, easy and efficient. Non-profitable though in the modern social order. So the tax-payers will keep wasting money for the professors working on the pharma orders with the only goal to increase the revenue of the last. And the tax-payers will keep dying paying that pharma for inefficient treatment of the diseases they have (am I communicating efficiently? :))

  8. Muirén permalink
    February 9, 2021

    You speak as a cultural chauvinist both in retrospect and in your views of the present.
    One can have all the evidentiary science lined up and still be laid low as an individual or in a gathering of peers by a shared implicit bias.

    Interesting regurgitation of the same insult Semmelweis suffered from during his lifetime, to justify the same implicit narcissism today and cloak it in a mantle of self-serving bad social science and historical half-truth.

    1) Though not a clinician as we understand it today, Semmelweis, contrary to popularized myth did credible research, thoroughly documenting his projects, so as to effectively analyse and form his hypothesis.

    This is taking gross liberties with historical facts to frame an apology.
    “Sherwin Nuland explains in The Doctor’s Plague, there’s more to the story than first meets the eye. Semmelweis, thinking his results were enough, didn’t see the value in communicating his work effectively, formatting his publications clearly or even collecting data in a manner that would gain his ideas greater acceptance.”

    2) The method of his extracurricular research where consistent, if not in fact, exemplary in the ‘context of his time’. Your holding up extraordinary examples of research by others whose methods that more closely resembles modern practice over a decade after is problematic because they took place 30 plus years after Semmelweis voiced his concerns.

    3) It is a fact that he was rebuked for even suggesting the possibility of what he suspected before, during his research, and most certainly in the years that followed.

    4) We know as fact, that Semmelweis was convinced he had no talent as a scientific author, and that was the overriding justification he had for not publishing the details of his research at length until 14 years after the fact in “Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers”.

    5) Finally, it is absurd that are asked to believe the pointless death of millions is justified because one man offended the delicate sensibilities (and wallets) of the most vain, self-aggrandizing, wealthiest and privilege men of their day.

    Over the past 400 years little to no progress has been made by scientist themselves to squarely face and mitigate the toxic effects of Wealth, Social Class, Politics, Ethnicity, Race, Religion, Gender on the progress of science and its efficacy in serving the greater good of humankind.

  9. Adam permalink
    July 24, 2021

    Muirén great comment. This article bascially attacks the messenger instead the institution responsible for the death of millions for ignoring sound evidence. The medical establishment could have very easily tested the hypothesis but chose not to.

    We still see this today and people like the author subtly propogate the same arrogance and closed mindedness.

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