Similarity of Common Errors Made by Doctors and Leaders
By; Jeffrey M. Ferezan, Ph.D., MBA
Medical doctors and leaders share a common trait with those they are serving. It has been demonstrated that much thought goes into stabbing a person in the back, if you share the same values. Within groups of trusting individuals (hopefully you trust your doctor and your CEO); we have been primed to value intuition over reflection, and the ability for a fast diagnosis or decision leads us to then become more generous and cooperative. Joshua Greene a Harvard psychologist; explores these concepts in his new book, “Moral Tribes: Emotion, Reason and the Gap Between Us and Them.”
It appears a quick decision by a business leader seems to give us the confidence to move forward with little trepidation and the feeling of being championed. The same seems true when a doctor prescribes a plan of attack or remedy for what ails us; we rapidly accept and move forward to cure our ills.
A November article in the Wall Street Journal outlined, 13 common biases that can prevent a doctor from making the correct diagnosis by; Pat Croskerry, Dalhousie University.
After reviewing the findings, it was quite obvious the examples given were in line with very similar choices a leader could make given the same situation. Most all have to rely on the very basic commonsense trait we house within.
ANCHORING – Locking on to salient features in the patient’s initial presentation too early in the diagnosis process, and failing to adjust for conflicting or new information. The leader who makes a data driven decision (instead of a data informed decision), without having all the facts is guilty of this. Often referred to as a knee-jerk reaction.
AVAILABILITY – Recent experience with a disease may inflate the likelihood of it being diagnosed. Many leaders will use a recent challenge resulting in a successful outcome and apply the same successful solution to something that appears similar in scope, without exploring the real issue at hand. This may or may not work depending upon the amount of information they failed to know.
BANDWAGON EFFECT – The tendency for people on a medical team to believe and do certain things because many others are doing so. A strong leader knows the strength of a well-designed team is the ability to suspend judgment and allow all ideas to be explored. If the team is not monitored by the leader, then it is quite possible the team could fall into the ‘group think’ mentality.
CONFIRMATION BIAS – The tendency to look for confirming evidence to support a diagnosis, rather than look for evidence to refute it, despite the latter often being more persuasive and definitive. As leaders we do look for others using similar tactics. In recent years, think of the many retailers who have begun to open their doors on Thanksgiving evening to attract shoppers. These decisions are not made by local management but by leaders on a global perspective.
DIAGNOSIS MOMENTUM – Once diagnostic labels are attached to patients, what might have started as possibility gathers increasing momentum until it becomes definite and all other possibilities become excluded. An example of this could be the elimination of flex scheduling in the work place. Once a leader determines the 8:00 AM start time is convenient for the majority of employees, then a decision to eliminate other types of flexible and staggered starts comes into play.
FUNDAMENTAL ATTRIBUTION ERROR – The tendency to become judgmental and blame patients for their illnesses, rather than examine the circumstances that might have been responsible. Every leader could become guilty of this if not very careful in exploring the root cause of a person’s work habit deficiency. We may have placed them in a job they currently are not prepared or educated to perform successfully, how would that be their fault?
GENDER BIAS – The tendency to believe that gender is a determining factor in the probability of diagnosis of a particular disease when no such basis exists. More and more this notion becomes less of a challenge for leaders. It is proven that men have become great nurses and women have become great military officers. Leaders who are not in tune with this will not be leading within their organizations very long.
NEED FOR CLOSURE – Drawing a conclusion of making a verdict about something when it is still not definite, often when the doctor feels obliged to make a specific diagnosis under conditions of time or social pressure, or to escape feeling of doubt and uncertainty. An example could be a university president coming under pressure from donors, alumni and trustees to remove a head coach of a struggling sports program. In their gut they feel they have not given the person a fair amount of time to perform, but the overwhelming outside influences take over in the decision.
OUTCOME BIAS – The tendency to opt for diagnostic decisions that will lead to good outcomes rather than those associated with bad outcomes. Every leader creates scenarios where the win-win outcome is inevitable. Paying the yearly bonus in a given year even though the bottom line has suffered, would be an example.
OVERCONFIDENCE BIAS – A tendency to act on incomplete information, intuitions or hunches. Too much faith is placed in opinion instead of carefully gathered evidence. Due to time constraints, many leaders are forced to make decisions without having all the facts necessary. In most cases this will result in a redo of some sort. Reminding us of the old saying; it is better to build a boy then to repair a man!
SUNK COSTS – The more time and mental energy clinicians invest in a particular diagnosis, the less likely they may be to let it go and consider alternatives. Leaders spearhead projects at times that have a personal or vested involvement. It may or may not be in the best interest of the organization and money could be better spent in other areas or projects, much more lucrative or in-line with the organization’s mission.
UNPACKING PRINCIPLE – Failure to illicit all relevant information from patients in a medical history. The chairperson of the board of trustees asked his members to vote on choosing a search firm to engage in the selection of their new president. He became quite embarrassed when it was brought to his attention that one of his current board members was the former managing partner of a very successful, nationally known search organization.
ZEBRA RETREAT – Occurs when a rare diagnosis, or zebra, figures prominently, but the physician retreats for various reasons; perceived inertia in the system and barriers to obtaining special or costly tests, self-consciousness and under confidence about entertaining a remote and unusual diagnosis. The leader who becomes quite hesitant about sharing some news that may reveal an outcome with damaging or consequential impact.
The psychology behind our decisions is and will always be quite fascinating. It continues to be explored and researched by experts within many specific disciplines. The findings never cease to amaze those who continue to be interested.