August 30, 2013 by Merrick Furst .

Imagine you are a surgeon in the 1890s. Recent developments in anesthesia and antisepsis had made surgery much more practical. The great 19th century scientific project of categorizing and diagramming the physical world had spread to medicine with the publication of Gray’s Anatomy. Your training focused on dissecting cadavers and learning anatomy – so you have detailed knowledge of the proper size, shape, and placement of human organs.

Patients come to you with various abdominal pains and digestive complaints. You can tell by palpitating (and later through x-rays) that these patients have organs that are out of place. Result? Many diseases were diagnosed as being caused by “dropped organs,” and thousands of surgeries were performed during this period to raise organs back up to their proper place, where they were stitched to other abdominal structures.

Here are a few things we know now:

• The textbook descriptions of where organs ought to be were largely wrong. They were based on autopsies conducted on cadavers lying on tables; when human beings stand up, their organs drop down.

• The idea that health depends on organs being in their proper place is also mostly wrong. Organs move around a lot. This idea had more to do with Victorian sensibilities than medical fact.

• Nearly all of these thousands of surgeries were unnecessary, when they cured people it was by the placebo effect.
  Many of these operations were fatal.

We’re in an analogous situation today with respect to startup companies. Due to advances in distribution, programming, and outsourcing, it’s easier than ever to start a company, and thousands of startups are churning through accelerators, incubators, and demo days around the world. Due to unexamined assumptions and cognitive illusions, most of these companies are failing to create anything customers adopt, and are going bankrupt. Luckily, bankruptcy is almost never fatal.

Recent developments in lean entrepreneurship and commerce-related technologies promise to transform and accelerate the 21st century economy. But these technologies and business theories will only fulfill their promise by integrating with current insights and methodologies in behavioral economics, psychology, and philosophy.