PoS Sep 2017 | Finding the RIGHT doctor: A Case in Strategic Decision Making
Most people, especially managers, associate decision-making with work. This is a narrow view. Many of our most important decisions are about our health, wealth, and happiness. Consider the need to find the RIGHT doctor if you or a family member has a life threatening or debilitating condition that requires major surgery.
In such situations, we often choose a large and reputable hospital and trust the specialist they assign. Sometimes we ask friends and associates to recommend a doctor who has treated someone they know for a similar condition.
How biases take root
Choice of hospital is usually coloured by proximity and convenience of family members who will need to attend to the hospitalised patient (a peculiar Indian circumstance). The hospital is often and incorrectly considered as the proxy for the doctor’s expertise. A large hospital usually has many doctors in major specialities. The one we end up meeting may be randomly assigned.
Tiny sample size bedevils recommendations of friends and associates. Experiences of a couple of patients are hardly a reliable indicator of a doctor’s expertise. Hospital websites showcase glowing profiles of their specialists. How much should we trust them? How equipped are we to compare profiles and evaluate?
Where should we begin?
The Internet can be a starting point. Although doctors don’t like it, the Internet is a good place to learn about serious ailments, causes, and recent advances in treatment. This is never enough to evaluate a doctor’s abilities but it can prepare us for a meaningful discussion with doctors on diagnosis, treatment, and prognosis.
It is usually a good idea to consult more than one specialist if one has the time. It helps gather a broader range of opinion. If their assessments converge, one can be confident the proposed line of treatment is the correct one. If they diverge, it will point to the need for a deeper dive. Yes it will make it harder to choose the doctor and treatment, but it will probably be better than a single opinion.
When sizzle is not substance
Perhaps the most acute problem with finding the right surgeon or specialist is the effect of bias on our judgement. We may be impressed by a hospital’s snazzy facilities, courteous, friendly staff and assume doctors are more competent than elsewhere. The ambience of the doctor’s office, his demeanour, substance and form of his advice shape our judgement.
We like doctors who listen carefully, and appear reassuring. We tend to consider them more capable even though their behaviour is not a reliable indicator of professional accomplishments. The many certificates displayed on the wall may have something to say but we may not have the capacity to evaluate their relevance to our needs.
A friend of mine was dismayed to find a surgeon’s prognosis was overly positive when compared with three others he had consulted. He heeded that alarm bell.
Our medical condition has us in a delicate frame of mind. We worry if we may antagonise the doctor with too many questions. Will he agree to treat me? Will I get the best treatment at his hands? These concerns hinder objective assessment of the expertise or suitability of the doctor. The insidious problem with cognitive bias is that we remain unaware of flawed judgement.
Data, and more data
First, get more data. Read, research, ask knowledgeable people – other doctors for example – and learn more about the ailment, treatment, etc.
Find and list prospective specialists. Get to know more about them, consult and discuss with them approaches to treatment. Gain insight on what may work well, and what may not. Do not hesitate to ask questions. Many doctors appreciate having to deal with knowledgeable patients.
Finally, find a wise person who is not likely to be biased by your impressions, to be your sounding board. He will challenge your thinking, assumptions, and uncover errors of judgement, illusions, and delusions.
Decisions pertaining to our health are some of the most important we make. We simply cannot afford mistakes. Admittedly, it is difficult. That is why it merits greater diligence and objectivity.