Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Trust me, I’m an expert: the pandemic parade of pompous professionals

Charles Dinerstein, MD, MBA
Physician
September 20, 2024
Share
Tweet
Share

In a world where experts are our go-to for solving everything, the COVID-19 pandemic exposed just how fallible these specialists can be. Despite impressive titles and years of experience, many experts were just as clueless as the rest of us, often with unwarranted confidence. A recent study delves into the uncomfortable truth: the more knowledge you think you have, the less aware you might be of your actual ignorance.

We rely on experts and their expertise to help us solve problems, be it our individual health concerns with a physician or issues of policy that impact regional or national populations. The missteps of expertise during the COVID pandemic have generated a tidal wave of articles, ostensibly analyzing but more frequently blaming health or financial outcomes on the intent of experts. But what if these missteps, made at the edge of our knowledge, are generally more in the nature of expertise than in alleged deep-state conspiracies?

A recent study in the Journal of Behavioral Decision Making, which looks at experts and their knowledge, begins with an important but generally overlooked question: What is an expert? Merriam-Webster defines an expert as “one with the special skill or knowledge representing mastery of a particular subject.”

The researchers point out that the definition is too vague for quantitative research, and while the general field has no authoritative definition, expertise is frequently measured by professional titles or degrees, years of experience, and performance on “domain-specific” tasks. They also consider a more philosophical dimension to expertise—the ability to know what you do not know.

“To know what you know and what you do not know, that is true knowledge.”
—Confucius

The researchers suggest that we most desire this true knowledge, what we might call wisdom. Experts, as COVID-19 reveals, can profoundly influence our lives, but they are human, and their judgments are “not always accurate, and they can be overconfident.”

“We seek to understand whether experts, as classified by these criteria, can live up to the idealized conception of an expert from a philosophical standpoint.”

Dunning-Kruger effect

This study looks at a bias in our perceptions, the Dunning-Kruger effect, where people with limited competence overestimate their abilities (Dunning was one of the two authors of this current study). While Dunning-Kruger is often applied to the nonexpert, this work zeroes in on how this cognitive bias impacts experts and their opinions. They introduced two measures of “metacognition,” knowing what we know and don’t.

Murphy’s resolution: The ability to distinguish between correct and incorrect responses based on the respondent’s confidence. A high Murphy’s resolution means that the expert’s confidence in their answer is a reliable indicator of its correctness.

Yates separation: The gap between average confidence for correct versus incorrect responses. A high Yates’ Separation suggests that the respondent’s confidence is aligned with correctness—an individual knows what they do and do not know.

In short, the wise expert will have “a high Murphy’s resolution, a large Yates’ separation, as well as high confidence for correct answers and low confidence for incorrect ones.”

To measure an expert’s wisdom, they conducted studies involving climate scientists, psychologists, and investors. Each study identified a group of experts by title or degree and a group of non-experts found through online aggregators. Participants were asked a series of domain-specific questions and were asked to record their answer and their confidence in the response.

Unsurprisingly, experts demonstrated greater knowledge and more accurate self-assessments than non-experts. They showed greater confidence in those questions answered correctly than incorrectly. However, “they still made misjudgments that they held with confidence.” Those mistakes were an unfounded confidence in what they did not know—they were less aware of gaps in their knowledge than the nonexperts, leading the researchers to conclude that “awareness of error appeared blunted by expertise.”

ADVERTISEMENT

The research revised the results once they accounted for the difficulty of the questions, flattening the questions’ “hard-easy effect.” The improved calibration of experts disappeared, and they exhibited “greater overconfidence than citizens.” It may be that the unfounded confidence comes from their day-to-day experience with easy tasks, unlike those confronted during the COVID pandemic.

Defining expertise by years of experience rather than academic titles and degrees made no difference. While experts were better calibrated to what they know, the Dunning-Kruger bias leading to overconfidence is in full effect for knowing what they do not know. Expertise can generate unfounded confidence. We have seen this in several Nobel Laureates who have opined in areas outside their Nobel expertise; Linus Pauling and his views on vitamin C is a prime example.

“That is, experts had better metaknowledge regarding what they knew but equal or worse metaknowledge regarding what they did not know.”

Why might experts be just as impacted by the Dunning-Kruger effect as mere mortals? One offered explanation is what is described as a positive-biased reward system—rewarding those “showcasing” their knowledge with correct answers on tests. Tests that do not penalize wrong answers accelerate this bias. It is more challenging to say “I don’t know” or “I’m not sure” than to weave some plausible ideas into a possibly coherent-sounding fabric. No one wants their physician to end the conversation with “I don’t know.”

The answer may lie in another ancient concept, hubris—the quality of “extreme or excessive pride, dangerous overconfidence, and complacency, often in combination with arrogance.”

“In a sense, lacking knowledge itself is not a disaster; lacking the awareness of one’s lack of knowledge is. It hinders one from gaining knowledge, listening to others’ good advice, and making efficient decisions, and this is true for both misinformed bottom performers and experts. In sum, the work herein provides a cautionary tale about guarding against error in judgment and action: Being an expert means making more correct decisions, but it does not mean the eradication of all errors. Those errors may not be anticipated, so one must stay on guard against making errors, whatever one’s level of expertise might be.”

The unanticipated Dunning-Kruger effect seen in experts, as demonstrated in this study, provides a reasonable understanding of why our experts got COVID-19 wrong without positing some nefarious intent or cabal. Experts are human, and humans err. The real message in the COVID “root-cause analysis” is being open to divergent, dare I say diverse, views.

Charles Dinerstein is a surgeon.

Prev

Ways to overcome the grief of disillusionment about medicine

September 20, 2024 Kevin 0
…
Next

How to preserve your brain health [PODCAST]

September 20, 2024 Kevin 0
…

Tagged as: COVID

Post navigation

< Previous Post
Ways to overcome the grief of disillusionment about medicine
Next Post >
How to preserve your brain health [PODCAST]

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Charles Dinerstein, MD, MBA

  • Cognitive decline and surgery: the silent struggle doctors don’t talk about

    Charles Dinerstein, MD, MBA
  • Medicine’s struggle with genetic and social realities

    Charles Dinerstein, MD, MBA
  • Diverse data redefines heart disease prevention strategies

    Charles Dinerstein, MD, MBA

Related Posts

  • How the COVID-19 pandemic highlights the need for social media training in medical education 

    Oscar Chen, Sera Choi, and Clara Seong
  • Why this physician marched during a pandemic

    Raj Sundar, MD
  • The first day of medical training during a pandemic

    Elizabeth D. Patton
  • Drug ads are a campaign against physician trust

    Judy Salz, MD
  • Reimagining medical education from within a pandemic

    Kasey Johnson, DO
  • Building a bond of trust between patient and physician

    Michele Luckenbaugh

More in Physician

  • The hidden chains holding doctors back

    Neil Baum, MD
  • 9 proven ways to gain cooperation in health care without commanding

    Patrick Hudson, MD
  • Why physicians deserve more than an oxygen mask

    Jessie Mahoney, MD
  • More than a meeting: Finding education, inspiration, and community in internal medicine [PODCAST]

    American College of Physicians & The Podcast by KevinMD
  • Why recovery after illness demands dignity, not suspicion

    Trisza Leann Ray, DO
  • How physicians can reclaim control over medical malpractice risks

    Howard Smith, MD
  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why recovery after illness demands dignity, not suspicion

      Trisza Leann Ray, DO | Physician
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • Physician job change: Navigating your 457 plan and avoiding tax traps [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden chains holding doctors back

      Neil Baum, MD | Physician
    • Hope is the lifeline: a deeper look into transplant care

      Judith Eguzoikpe, MD, MPH | Conditions
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • From hospital bed to harsh truths: a writer’s unexpected journey

      Raymond Abbott | Conditions
    • Reclaiming trust in online health advice [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why recovery after illness demands dignity, not suspicion

      Trisza Leann Ray, DO | Physician
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • Physician job change: Navigating your 457 plan and avoiding tax traps [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden chains holding doctors back

      Neil Baum, MD | Physician
    • Hope is the lifeline: a deeper look into transplant care

      Judith Eguzoikpe, MD, MPH | Conditions
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • From hospital bed to harsh truths: a writer’s unexpected journey

      Raymond Abbott | Conditions
    • Reclaiming trust in online health advice [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...