Ditch Deference and Challenge Experts
From Harley Street to the Mayo
I am sick, really sick. I look in the mirror and see hollow cheeks, eyes ringed with tiredness. I am weak. Walking to the end of my street feels like a huge effort. My weight has plummeted by thirty pounds in just three months. In swift succession I have transformed from slim, to thin, to very thin, to looking ill. On doctor’s orders I stuff my face with cream cakes, chips and plates of buttered bread. Yet my BMI remains dangerously low; I gain no weight. If anything, I am getting ever thinner.
I’ve done the round of doctors. From London’s Harley Street to New York’s Mount Sinai, from Chicago’s Mercy to the Mayo Clinic in Minnesota. I’ve been prodded and pinched, have put on and taken off paper knickers and back-tying hospital gowns more times than I’d care to remember. I’ve been ultrasounded, X-rayed, MRI’d and CT’d with contrast and without. My blood has been drawn so often we’re now looking for veins in my feet. I’ve swallowed a camera in a capsule, seen my guts in slo-mo and had tubes down my throat. I’ve been tilted and shocked, my hands have been heated and then plunged into ice. I’ve been pitched a variety of treatment plans.
Surgeons suggest a range of procedures, from exploratory fact-finding missions to the immediate removal of my (perfectly healthy, and I feel irrelevant to my symptoms) gall bladder this very week. The Professor of Nutrition (so revered he has a three-month waiting list) suggests I eat mainly sugar. The world-renowned gastroenterologist tells me of his personal success with Prozac, and recommends very strongly that I try that. At the impressive Mayo I have two weeks of tests and examinations, yet they suggest I come back and be tested more.
But I don’t want to live off sugar, am keen to pass on Prozac – my mental state is fine, while the famous doc seemed pretty loopy – and I would rather not succumb to more investigations. As for surgery – not that appealing, especially as I’m feeling so very weak. And what are they actually looking for? I’m not up for having body parts removed on a whim. And even if surgery is the right decision, which operation? And which surgeon?
What to do? Who to put my trust in? Which expert to pick? What to decide?
Men in White Coats
In an age of disorder, deluge and disruption, a time when we are ever more conscious of marketers’ attempts to mislead, we crave answers and certainty. And experts sell both in spades.
Scientists, professors, doctors, lawyers, investment advisers, management consultants, specialists in a wide range of domains and fields. Men (typically) in white coats or pinstripe suits, usually grey-haired – you know who I’m talking about: the authority figures we see on our television screens or read about in our morning newspapers. The kind of people deemed ‘trusted sources’ on a particular topic, usually but not always their own. We find their utterly self-confident, parent-like aura very reassuring. When they tell us what we can and should do, or what we can’t, it’s a real relief.
I mean, ever since the Enlightenment we’ve acknowledged, haven’t we, that science and logic are supremely privileged forms of knowledge, to be much revered? And it’s experts who know the passwords that provide access to this privileged world. When an expert confidently delivers his opinion, we can almost see centuries of theories, rules, principles, experiments and formulae being channelled through him, in a special secret language that we, the non-experts, are not privy to.
We take these words of supposed wisdom at face value – we can’t understand what the experts are on about most of the time, but we nod anyway, and accept what we are hearing. Bludgeoned by their stats and theories, pacified by their institutional affiliations and the letters after their names, reassured by their self-confidence, we surrender our intellect, instincts and power to them.
They know the answers. We do what we are told. It’s a tyranny of the experts.
This is no exaggeration.
In a recent experiment, a group of adults were asked to make a financial decision while contemplating an expert’s advice. An fMRI scanner gauged their brain activity as they did so.1
The results were extraordinary: when confronted with the expert’s advice, it was as if the independent decision-making parts of the participants’ brains pretty much switched off.
An expert speaks, and it’s as if we stop thinking for ourselves. It’s a really scary idea.
Yet we don’t even suspect that there’s a problem. Indeed, studies show that the vast majority of college-educated, high-earning, informed adults, CEOs, professionals, executives – people with clout, experience, wisdom of their own, people perhaps like you and me – trust experts more than any other group in society.2
But remember how easily misled we were by Professor Miner in the previous Step …
The Sham in Expert’s Clothing
Even fellow experts prove to be overly trusting. In a revealing experiment first conducted in 1972 by a group of professors of medical education from the Universities of Southern Carolina and Southern Illinois, and repeated in many other contexts since, ‘Dr Myron L. Fox’ supposedly an authority on ‘the application of mathematics to human behaviour’, but in reality an actor named Michael Fox, addressed a lecture hall full of professionals from his supposed field – psychiatrists, psychologists and social workers.
‘Dr Fox’ spoke on the subject of ‘Mathematical Game Theory as Applied to Physician Education’ for a whole hour. He then took half an hour of questions. From the feedback forms collected after the lecture, we know that his talk was extremely well received: ‘Good analysis of subject’, ‘Excellent presentation’, ‘Extremely articulate’ were among the comments made. This despite the fact that the material he delivered was actually meaningless – full of ‘double talk, neologisms, non sequiturs, and contradictory statements … interspersed with parenthetical humor and meaningless references to unrelated topics’.3 Other studies have similarly found that the more verbose an academic is, the more competent he or she is taken to be.4
In this case, not a single audience member saw through the hoax. One even claimed to have read Dr Fox’s publications.
The experts’ accessories – the doctor’s stethoscope, the fund manager’s pinstripe suit, the professor’s lectern, the framed certificates and convoluted lingo – all serve as proxies for their reliability and trustworthiness, and protect the frauds, fakes and incompetents as well as your everyday expert.
From Monkeys to Garbage Collectors
But experts do get things wrong. A lot wrong. I’m not talking here about tricksters like Dr Fox. Or fraudsters such as Hwang Woo Suk, the South Korean stem-cell researcher who claimed to have created the world’s first cloned human embryos, but hadn’t. Or the 2 per cent of scientists who admit to cheating outright – falsifying or fabricating their results.5 I’m talking about your run-of-the-mill expert and run-of-the-mill error.
Did you know that studies have shown that doctors misdiagnose one time in six?6