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Yes. It is pretty common, though not everyone defines or utilizes “placebo” in the same way.Short answer: it does sometimes happen, does not always violate patient rights, and can yield a better cost/benefits ratio than conventional ‘active treatments’ in some situations. Placebos are not confined to clinical trials, whether in the past or the present, and placebo prescribing is not solely about inert substances.Factors like the professional dynamic and the patient’s treatment setting can elicit effects just as relevant as physical medical interventions, even if we don’t have a mechanical understanding of exactly how and why. The unifying trait of placebo is not a lack of influence, but rather a lack of specific and intended mechanisms towards particular treatment goals.Longer answer: To read more about certain facets of this oft-oversimplified matter, I have also included a fuller post for the more ambitious or less occupied browsers. Skip to the end for data gathered from peer-reviewed medical journals addressing the topic and expressive details of placebo prescribing.Section I. What is placebo prescribing?There are no predefined properties of “placebo” prescriptions because the placebo effect is about how patients react rather than what is prescribed. Though debate exists as to exactly what constitutes a “placebo”, the basic feature common to most definitions is a placebo acts through something other than the ‘active mechanisms’ specific to the drug, procedure, or product approved or normally used for particular situations. It is a way of saying “We don’t know why someone is benefiting”, even if that benefit can be statistically predicted.“Placebo effect” is an umbrella term for a wide variety of effects, from personal beliefs to social expectations to treatment environment and beyond. Placebo is defined by what it is not rather than what it is, contains, or does. Treatments that have no illuminated or conventionally reliable mechanism of action can often be termed as placebos, regardless of how effective or ineffective they are. And this is keeping in mind that “treatment” pertains to a specific use of a particular technique towards predefined outcomes—efficacy is measured relative to those priorities.Two common misconceptions are that “placebo” means someone has to be in the dark about what they are taking, or that they have to expect a positive response in order to experience one. Neither of those things is the case, though both of those factors can influence some patient outcomes. As discussed, “placebo” is not any single kind of mechanism, and contains pluralistic and potentially even competing influences. It is the term used for the range of influences that are grouped simply based on not being the result of a specifically intended and physically efficacious treatment mechanism.What is grouped as a “placebo” in some settings could be an ‘active treatment’ in others, depending on the kind of placebo being discussed and what is being treated. Placebo is about how we relate intention to mechanisms. Both in ‘actual practice’ and in clinical trials, what someone is prescribed as a placebo will sometimes be ‘active’, but not active in a way specifically relevant to what is being treated. Other times, it can be something that is not an ‘active’ part of any treatment—something as close to inert as a medical intervention is capable of being.No intervention is truly inert, however, as any kind of interaction has repercussions. This complexity and sensitivity is part of why clinical trials are difficult to construct and also why the “placebo effect” seems so mysterious in the first place. It is a way we deal with an entire swath of dynamics that we lack an adequate understanding of. In the future, many influences often grouped as “placebo” in the present may be harnessed as specifically defined ‘active treatments’. Understanding and application change over time even if certain treatments or treatment outcomes stay the same.Section II. When and why do doctors prescribe placebos?Put most briefly, doctors prescribe placebo in at least three circumstances: when they feel like it, when it is easier, and when it is better. As there are different kinds of reasoning behind prescribing placebo, and doctors do not have to lie to patients in order to prescribe placebos, the ethical aspect of the situation is more heterogeneous and complex than some people may think. Like with other kinds of prescribing, there are both ethical and unethical uses of placebo prescribing.It is true that not all physicians knowingly prescribe placebo treatments, but a substantial proportion of them do and even admit to doing so. Placebo prescribing appears to be more commonly or obviously noted in particular areas of medicine, for a variety of reasons, though what changes more often is what kind of placebos are used and towards what intended results. Not all doctors will prescribe placebos for the same reasons or at the same frequency, but some of the most common overall situations include times like:When it is more cost-effective while providing similar gains as ‘active treatments’. This is a particularly attractive in situations where conventional therapies are cost-prohibitive but providing inadequate an inadequate cost/benefit ratio for some patients or patient circumstances.When the risks of ‘active treatments’ far exceed those of placebo despite similar effectiveness or overall outcomes. Assessments must take into account projected efficacy and the comparative risks and possibility of negative of worsened outcomes when evaluating alternatives.When a patient knows it is what they are or might be getting and trust the clinical reasoning involved. Not everyone cares what they are being given as long as it works out for them in that particular situation, though informed consent should still be utilized as the interface when waiving the right to know most explicitly every time a placebo is being prescribed.When doctors mistakenly believe they are prescribing an ‘active treatment’, generally due to bad information or poor education. This is not “knowingly” prescribing, per se, but can be the result of failing in one’s duties as a prescriber. Drug and medical technology company marketing tends undermine rather than enhance prescriber understanding.When the conventional ‘active’ treatments failed to perform adequately, and placebo is either an adjunct or an experimental replacement before moving on to something more dangerous or even less likely to work. Not all concerns have successful or even approved-but-marginally effective treatments.Section III. Is placebo prescribing beneficial or appropriate?Because the “placebo effect” encompasses many factors that are present even in purposefully ‘active treatments’, it is always something which has the capacity to improve patient experiences and outcomes. That is, a placebo does not need to be prescribed for the “placebo effect” to play a role, just as “nocebo effects” (undesirable or detrimental placebo reactions) do not depend on a treatment itself being active or ‘fake’. This can pertain to expectations, but extends far beyond just how a patient feels about the treatment they are using.“Placebo” is not equally good at handling all situations and concerns. Not only are individual responses variable, and dependent upon wider context to an extent, some conditions will simply be far less responsive to many forms of placebo commonly used. It would also be misrepresentative to claim that all forms of placebo are interchangeable merely because they are placebo, or that any form can be highly useful for any situation. The extreme range of influences that are grouped as “placebo” does at least give doctors and patients a lot to work with if they want to explore that gamut.Ultimately, “placebo” is just the label for stuff we don’t understand from a mechanical perspective. It does not imply a technique has no potential to benefit someone. Indeed, we can see effects and results without knowing exactly how they come about. The more kinds of “placebo reactions” we learn the workings behind, the more we can effectively use certain techniques as purposeful ‘active treatments’. Sometimes we even discover that assumed mechanisms of action with ‘active treatments’ were, in fact, not the source of observed benefits being observed. Medical science has an exceedingly limited understanding of how things actually work.With the question of benefit also comes the question of appropriateness. Just because there is a potential to benefit, with many opportunities for placebo prescribing, does not mean they are also appropriate times and ways to use placebo. It is not a universal perspective, but I argue that informed consent should be a foundation of acceptable medical practice. If people are to be prescribed placebo, they should get to choose how much to know about that kind of prescribing, including when and why it is occurring and what the alternatives are. I have a post elsewhere more extensively discussing the practical issues involved: Mark Dunn's answer to Should doctors prescribe placebos?I think there are multiple frameworks that can support ethical and patient-driven placebo usage, but the medical industry does not strongly favor accountability to patient rights and interests. Thus, the liability for abuses in placebo prescribing is profound, especially because the current system already gravely fails patients in the areas of informed consent and accountability for preventable harms. While I don’t think we have a system that can responsibly transition to increased prescribing of placebos in appropriate and consensual ways, that placebo prescribing is an enduring and perhaps even inexorable phenomenon in medicine means our focus should remain on patient rights, needs, and outcomes.Section IV. How often does placebo prescribing really take place?Frankly, nobody really keeps track of how often placebo prescribing goes on, and whether instances involved ‘active’ versus inert placebos. Only surveys, smaller studies, and epidemiological data tend to inform us about the scope of the issue, though individual comments from doctors and other medical professionals can give us insights about the nuances and range of prescribing within their own respective scopes of experience. What we do know is that it is a common, global, and ongoing practice.For example, when defining “a ‘placebo treatment’ as a treatment whose benefits (in the opinion of the clinician) derive from positive patient expectations and not from the physiological mechanism of the treatment itself”, a 2008 study of 1200 physicians concluded that “prescribing placebo treatments seems to be common and is viewed as ethically permissible among the surveyed US internists and rheumatologists.” [1]That study mentions saline, sugar pills, over-the-counter analgesics, vitamins, antibiotics, and sedatives as examples of placebo treatments doctors reported using. It also stated that “physicians who use placebo treatments most commonly describe them to patients as a potentially beneficial medicine or treatment not typically used for their condition (241, 68%); only rarely do they explicitly describe them as placebos (18, 5%).” [1]Another study, this one from 1981, found that 80% of the 300 staffpersons surveyed at a university-based general hospital had used placebos, with 89% of placebo use being focused on addressing pain complaints. [2] Further studies into regional and global healthcare trends have noted that the prescribing of placebos is common within primary care as well as many specialist contexts, with preference sometimes being given to placebo treatments with active ingredients (aka “impure placebos”) and with drugs accounting for the majority of placebo treatments overall. [3–8]ConclusionIn the distant and not-so-distant past as well as the very present, placebo prescribing is common, is not always ‘covert’, and the forms and applications of placebo are multifarious. Placebo use is sometimes focusing around specific concerns more often than being a catch-all treatment option, just as we see with approved ‘active’ therapeutic methods. Anyone denying that doctors prescribe placebos in real-life settings is ignoring the evidence and the reports of doctors themselves, regardless of what country or continent we examine.There will surely be doctors and other medical professionals who say “I don’t do that; I’d never do that!” and that is sometimes true! However, they may very well comprise only the minority of physicians. Exactly how “placebo” is defined can radically alter responses by prescribers, but even very conservative and explicit definitions utilized by studies have yielded that the placebo prescribing is neither rare nor a trivial occurrence.I encourage everyone concerned about the conduct of their own prescriber to ask some pointed questions to get an outline of how and why their doctor prescribes as they do. Not everyone will be transparent about their behavior, but you may learn something useful. Attitudes, behaviors, and commitment to accountability can vary between cultures, regions, times, fields, and individual practitioners. Like any other specialty consulting professional, finding a doctor who integrates with your personal values and priorities and helps you achieve the results you desire can hinge as much on their person as their professional qualifications.References:[1] Prescribing "placebo treatments": results of national survey of US internists and rheumatologists.[2] A survey of placebo use in a general hospital.[3] Placebo Trends across the Border: US versus Canada[4] Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners[5] Placebos in clinical practice: comparing attitudes, beliefs, and patterns of use between academic psychiatrists and nonpsychiatrists.[6] Use of placebo interventions among Swiss primary care providers[7] Frequency and circumstances of placebo use in clinical practice - a systematic review of empirical studies[8] Deliberate use of placebos in clinical practice: what we really knowPrevious Quora answers which were modified and edited together as part of this post:Mark Dunn's answer to When do doctors prescribe placebo pills to patients?Mark Dunn's answer to How do doctors prescribe placebos? Do they leave a secret mark on the prescription for the pharmacist?

Top 10 Best Strategies for Business Success1. Planning, Planning, Planning“You need a destination and you need a map to get there.” That is the role of a business plan, explains Bob Wilson, co-principal of Stoney-Wilson Business Consulting, which specializes in helping small and medium-sized companies with their banking needs. Key to the exercise is an honest SWOT analysis — strengths, weaknesses, opportunities and threats. Wilson notes that other people will want to see the plan — such as lenders, insurance companies, bonding companies — but emphasizes, “The primary reason you’re writing it is for you; it will be your bible on how to get where you want to be.”A business plan helps the business owner to think through issues and understand problems. It’s the shorter-term plan — 12 months — as compared to the longer-term strategy plan. The shorter term enables greater accuracy in completing the action steps to achieve the key initiatives, Wilson explains. The company’s co-principal Julie Stoney recommends the plan focus on only three to five key initiatives, as each initiative will require several steps. Among the steps for “growing the business,” for instance, may be acquiring a complementary business, developing new product lines and franchising.Knowing the competition is an important component of a business plan. “In order to compete, you must understand what the competition is doing, such as pricing and service levels,” Stoney says. “It will also help you identify if there is something complementary that your business should be doing. You can identify holes in your own organization or in the industry you can address, and satisfy a need.”Also helpful to a business owner is an advisory board. “With an advisory board, the business owner surrounds himself with expertise in a lot of areas, and it becomes his touchstone on a go-forward basis,” Stoney says, noting that many business owners have no one to turn to. “An advisory board also increases accountability to the business plan — what’s been said, what’s been done, new steps.”2. Funding a Successful BusinessAdequate and appropriate funding is an ongoing necessity for a healthy business. “With a growing company, it’s always a matter of ‘when,’ not ‘if,’” notes Jerry Mills, founder and CEO of B2B CFO, which provides financial and strategic solutions to small and mid-market companies. In addition to planned growth strategies, he refers to such things as a Department of Labor audit, Environmental Protection Agency regulations and significant increases on healthcare or liability premiums as he points out, “There’s always some surprise out there that we don’t know will happen.”For this reason, he advises business owners to develop a relationship with their bank before the need for a loan arises. Observing that it’s typical to rush to the bank with an urgent need in an emergency, he says banks “don’t work well in that situation,” and cites the Dodd-Frank Act and other regulations since 2008 that banks must follow and that make lending more difficult for them.Recommending community banks as easier to work with than national ones, Mills suggests seeking a loan or a credit card when the business does not need it, and using it just to develop credit and a personal relationship with the bank. This is a strategy he recently followed for his own company. “My company has no debt, but there are things we will want to do in the future. I asked for a credit card and got one within 20 minutes. We’ll buy things with it and pay the charges when they’re due.” Having established credit with the bank is handy when the business needs money that might be harder to get, such as working capital. “It makes it easier for the banker to say, ‘Yes.’ When he goes to the loan committee, he can say he’s known you for a long time, and you’ve always over-performed.”3. Branding, Marketing & ImageBranding and marketing is an essential part of business, says Beau Lane, CEO of full-service strategic marketing agency LaneTerralever. “It’s how the world views you; it’s their emotional connection to what you’re selling.” In today’s always-on and connected world, there are more channels to reach people, but Lane notes the essentials are still in good communication. “Take the time to understand your customer and consider how your customer reacts to what you’re saying.” It’s best to be simple, direct and defined in terms of what is being communicated. In spite of short attention spans, smaller screens and limited time, Lane says, “What’s exciting and challenging in today’s world is, there are more ways to have that interaction with the customer.” Plus, the digital world enables businesses to track results and see customers’ behavior and how they are reacting.But before anything else, Lane emphasizes the importance of strategy as a foundation for any marketing effort. “It’s easy to create marketing materials, but the magic comes if you have strong strategy behind that, that’s focused on objectives you have and targeted to customers you’re trying to attract.”Social media can be a tremendous asset to any business by building a network of followers, friends and supporters it can count on, but, Lane cautions, there must be value provided in the relationship. “It’s successful if you’re contributing to a dialog or adding value to what you’re offering in the marketplace, but it can be harmful if your content has no value.” And while it can foster and continue a relationship, it is no substitute “for two people looking each other in the eyes,” Lane says. Describing business as a “contact sport,” he says relationships and trust are necessities — and they are best built face to face with people.4. Sales to Drive RevenueA new technology or “best” of a product or service may be the foundation for establishing a business, but when the market gets competitive or the business hits a plateau, the predictability of cash flow becomes unpredictable. Sales is the side of being in business that provides predictable revenue growth, but sales trainer Mike Toney, founder and CEO of Conquest Training Systems, notes there are three methodologies: transactional, focused only on a quick sale and closing the deal; trusted advisor, working with a customer on a problem the customer recognized; and strategic partner, bringing a solution to a problem the customer had not known he had.Toney shares six important aspects of sales. These are “Society” — knowing who is being targeted and who is the ideal client; “Silo” — identifying the niche(s) the business can dominate; “Solution” — recognizing the problems the business can solve that no other businesses can solve; “Strategy” — developing a plan; “Structure” — accountability, management and compensation of the sales force; and “Systems” — the methodology that the business deploys.A common problem, according to Toney, is having the wrong type of salesperson for the desired role, such as a transactional sales representative in a strategic role. Noting that most salespeople will show up to “sell” themselves to fill the job, Toney observes, “Most owners don’t know how to hire.” It’s important to not have a “softball interview” but to put pressure on the applicants so that they can’t stay in their safe mode. The owner can learn more about the salesperson by seeing where he or she “cracks.”But even before that, the owner must be able to articulate exactly why his company exists; for instance, whether its strategic purpose is the solve a problem or to move product.5. Managing People, Process & BenefitsWhat makes a business successful, says Stephanie Waldrop, principal of Employee Benefits International, “has a lot to do with its ability to attract and retain quality employees who will be the face of the business.” A benefits program as part of a company’s compensation package is a tool to build loyalty within an employee pool. “It shows how much an employer cares about them. And employers who care get employees who care.”A lot of attention has been focused lately on healthcare, as discussed in the three-part healthcare series that concludes in this issue. But specific benefits aside, Waldrop states, “The No. 1 thing employees want in a benefits program is stability.” It’s important for employers to have a strategy to create that stability, from managing cost to creating a three- to five-year plan of what they want the program to look like. “This allows them to avoid a knee-jerk reaction, such as slicing benefits to offset a renewal increase.”An employer can achieve a win-win by surveying the employees as to what’s most meaningful to them — but limit the choices to items the employer has already determined are within his budget and he’s willing to act on.Also, there are benefits an employer can offer at no cost to the business, sponsoring them but making them available on a voluntary basis. Items such as life insurance and income protection may be available only in an employer setting, or be richer than what is available outside of that setting, Waldrop explains. “[Providers} assume higher participation rates because it’s a group setting and done through a payroll deduction.”There are other elements of company culture not tied to benefits, Waldrop points out. Among them is arming employees with training so they’re empowered in the position they’re charged with. “Employees feel better about what they do if they’re properly trained and empowered in that role.”Another plus is making employees feel a part of the company’s success, such as offering profit sharing or bonuses based on hitting the company’s revenue and retention goals. These can be structured to fit within the employer’s budget and proportionate to the individual’s pay level. Says Waldrop, “The motivation to find the ‘yes’ answers and ‘can-do’ responses for clients will make all the difference in the long run.”6. Operations & Accounting“Accounting is important when you’re starting a business. You’ve got to know what you’re getting yourself into, and numbers can help you figure out if it will be overwhelming, if you can handle it, if you need help,” says Chuck McLane, lead managing director at accounting firm CBIZ.Focusing on addressing the tax side of accounting, CBIZ managing director Zandra O’Keefe shares, “Financial statements show the health of the business. They are the basis of tax planning and tax prep.” Planning encompasses building wealth, paying taxes, providing benefits to employees, and compliance measures — and compliance, she notes, is an area that is always evolving, which is why she emphasizes the importance of having competent people in-house to help the business stay on top of compliance measures as well as to be able to “follow the cash.”“Make sure you understand the ins and outs of cash and the timing of that. That’s crucial,” says McLane. Creating a model of the cash flow enables a business to get a better sense of the timing of inflows and outflows, so that when money comes in, the business owner does not distribute too much too early and then not have enough when debt repayment comes due or for deductions for fixed income, or payroll or sales tax, or other obligations. In a nutshell, “Income does not mean cash, and vice versa,” O’Keefe says.Dealing with customer debt is another issue. How risky is the client? Should the business collect a retainer up-front? “It’s important to understand the norms of the industry,” McLane says, noting this, too, will help the businessperson understand the broader picture of what the business’s cash requirements will be over time.There are also a few specific tips O’Keefe and McLane feel are important to share. “Get an EIN (Employer Identification Number) instead of using a Social Security Number, because of the threat of identity theft. When you give 1099s to vendors at the end of the year, use your EIN and business name,” O’Keefe says.“Keep your business account separate from your personal account. A lot of small businesses start with the personal credit of the owner to give the starting point. But it’s important to have the discipline to separate the two, to keep track of the flow of funds — even if you have to do a transfer of funds from personal to business,” McLane says.“Talk with an attorney about the business structure that would be best, when you choose your type of business entity. There are compliance issues around fringe benefits and tax level. For instance, in a partnership, the partners do not get a W2, and they can’t participate in an employee cafeteria plan — in fact, if they do, it would become taxable for all the employees. Entity selection is critical,” O’Keefe says.“For financial reporting, establish good policies and procedures from the beginning. Have consistent policies and procedures in place, so that as you add people to the organization, you will continue to record transactions in the same consistent manner,” McLane says.7. Retaining Customers, Maintaining CommunicationCustomer service is the differentiator, says Tyler Wirtjes, GoDaddy vice president of customer care. “Whatever you build today, in 60 days 30 companies can copy that product. But they can’t duplicate the people — the interaction with your customers that you put in place to have that contact with your customer.”The No. 1 focus should be trying to build a relationship, not just complete a transaction, he says, adding, “I think that’s sometimes forgotten.” This may mean going a step beyond whatever prompted the initial contact. Using his company as the example, he says that, in solving a customer’s issue, the service consultants ask the customer what he’s trying to accomplish with his business, so as to understand how he’s relying on GoDaddy. “Find out why they’re using you,” he says. “Help them find whatever success you can in using your product or service. That’s when they get emotionally attached to your company.” This is important in proactive contact as well as in reactionary response to complaints.Wirtjes acknowledges that technology enables many functions to be automated, such as virtual assistants programmed to handle FAQs. “Artificial intelligence has come a long way over the last 10 years.” But what sets a business apart is delivering a personalized experience. For this reason, even a real person may not accomplish that relationship-building if the “conversations” are too rigidly scripted. “No one wants to call up and talk to a robot that’s actually a human but you think it’s a robot,” Wirtjes says.Thanks to social media, complaints and issues today travel fast. Ignoring them can hurt a business’s brand, but dealing with them can, potentially, promote it. Explains Wirtjes, “If you take care of them in the public forum, you can gain followers to your brand or service or product because of the way you engage with customers and the way you solve their problem.”8. Technology that Matters“Technology is important for its ability to help all businesses scale — to provide repeatable and consistent results with what they do for their customers,” says Clint Harder, chief technology officer and senior VP of product strategy at OneNeck IT Solutions. He also points to the advantage technology brings by enabling business owners and executives to connect directly with [all the people they do business with] — customers, partners, vendors.”Cloud outsourcing has become appropriate for businesses of all sizes, Harder observes, explaining that instead of a business consuming technology with its own capital and bringing it into its physical location, the cost is an operating expense remotely delivered.Under the broad umbrella of “technology” are items developed for specific types of businesses or industries, and the smaller companies that do not have a department dedicated to researching and updating advances that could be useful to them “get that type of advisory and forward-looking education from vendors they partner with for their IT,” Harder says. Professional services organizations, whose inventory is people and time, require a program to help manage labor costs and billing rates as well as needs around document management. Retail focuses more on business processes — inventory of merchandise, manufacturing cost, delivery systems to get goods to locations. And getting detail-specific within industry-specific, Harder notes that dealing with certain types of oil wells requires specific engineering technology software and hardware.“Technology” also encompasses the type of service OneNeck provides — helping run all the other technologies that support specific applications. The point is to protect and monetize the data. Says Harder, “Everything else can be bought in a commoditized component basis as an operating service, such as data co-location or cloud computing.”Noting that core company information technology becomes purely obsolete in five years, and has degraded capability — although is still functional — in just two to three years, Harder says, “Using the cloud puts the obsolescence risk on the provider rather than on yourself.”9. Personal Decisions, Actions & EnergyPeople who are successful are generally never satisfied with the status quo; they need to keep creating. But Patricia Noel Drain — speaker, author and business mentor — counsels, “Make sure you’re satisfying your needs when you’re leading the company. Forgetting about yourself and only taking care of others is not being a good leader.” She recommends, in fact, “Put yourself on your calendar.” And when pushing out of the comfort zone, the most important thing is to “stay true to you. Consider, ‘Does this feel good to me?’ If not, you’re going down the wrong path.” To grow their business, she’s found that people have to be happy in it.The oft-quoted advice is “Work on your business, not in it.” Creating systems for all aspects of the business operation enables the business owner to delegate responsibility, and Drain notes that creating systems is what creates the value in the company. “Determine where you build the systems based on your own passion. This elevates you to still be the visionary for the company.”Of course, recruiting, motivating and retaining great employees is important. Drain underscores a difference between great and mediocre as she articulates, “Make sure you have systems in place to retain your really great employees.”And with the systems in place and great employees on board, Drain says, “If you want to take the business to the next level, you have to get out of your own way.”10. Mentoring & Community InvolvementVisibility and connections enhance the growth potential of a business. Community involvement provides opportunity for a businessperson to benefit in both areas in addition to helping make a positive impact on the community he or she is part of. Christy Moore describes it as the “power of having deep relationships and connections with other community leaders, so they can leverage that connection to help with whatever they’re trying to achieve.” Moore, executive director of Valley Leadership, notes that mentoring is key as it brings together emerging and seasoned leaders. “It allows the mentor to leave a legacy behind and have a significant impact on an individual, and the mentee gains wisdom and insight from a seasoned professional.”The purpose of Valley Leadership’s program is to educate people about community issues; it is not a formal mentoring group. But mentoring and connections are a key focus and a significant reason to get involved. “We bring together diverse groups of individuals who may not otherwise meet or interact,” Moore says. Participants gain a better understanding of varied community and business sectors and different — even opposing — perspectives. Furthermore, project groups within each leadership class — who work together to accomplish a sustainable community project that fulfills an identified need — are purposely composed to comprise what the field of energetics calls a “full brain,” combining people whose strength is in social thinking, conceptual thinking, analytical thinking and structured thinking.