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Does America have an expert crisis? February 7, 2022

You know the old adage, “too many chefs spoil the dinner”.  Now we can say that about our health, as well. As a practicing family doctor for the past 20 years, I’ve seen countless times how too many specialists can “spoil” a patient’s health. A cardiologist starts two blood thinners to keep the patient from another heart attack, but then finds that the patient died of a bleeding ulcer from the blood thinners. A psychiatrist starts another patient on antipsychotics for bipolar disorder, and doesn’t even know that the patient developed uncontrolled diabetes several months later as a consequence. An orthopedic surgeon replaces a knee in an elderly patient who can never start exercising again due to worsening dementia from surgery complications.  All of these scenarios happen, and a lot more than you’d think. These were all experts, doing what they do best, in their particular field. But in the end, bad things happened. 

 

Experts are rewarded for the experience and education they invested in, in order to “hack” the system for the non-experts. This is why we pay a lot of money for celebrity divorce lawyers, horse dentists, sub- particle theoretical physicists, and liver subspecialists. Focusing like a laser on one problem makes us very valuable to society in one way or another. However, what happens when that problem reaches outside of our area of intense focus, what then? What if the problem is so large that none of the experts, when put together in a room, can see the bigger picture perspective? 

 

The COVID-19 pandemic has shown us that we may very well have an expert crisis in America. First, we have expert molecular virologists, expert viral epidemiologists, expert infectious disease physicians, expert disease modelers, we have expert impact economists, expert science policy advisors, expert clinical researchers, expert social scientists, and so on… You get the point. There are a lot of experts out there. Having experts is great…when they work for the intended purpose. Just like a chef’s kitchen, too many experts may actually make things worse. A lot worse. 

 

This problem is exacerbated by our own human nature. When as an expert, I am called upon by a non-expert, I need to look the part, I need to act the part, I need to be the part that is expected of me by whomever hired me. I believe that many experts may actually be terrified of being thought of as “incompetent” by others and work very hard to maintain their image. Unfortunately, too many experts, simply by virtue of their position, have become rigid in their perspective of any situation at hand. This is something called confirmation bias, and it seems to be a growing part of why I say that America has an expert crisis. I see what I see, because I want to see it. The same thing happens when a group of experts come together and create “consensus statements” that conform only to their group’s worldview. 

 

After all, it was “experts” who derided Semmelweis’s germ theory of disease. It was “experts” who belittled Barry Marshall’s discovery of H. pylori bacteria as a cause of peptic ulcers, it was “experts” who possibly killed our nation’s first president by bleeding him to death to treat a throat infection (likely diphtheria). It was “experts” who persecuted Copernicus and Galileo, Pauling and Einstein, just to name a few. How do we cure ourselves of our love affair with experts? 

 

First, do your own homework. Think for yourself. Use Google Scholar and Pubmed. Trust, but verify. Get engaged. Stop using media news as something you believe in blindly. Trust yourself to find answers.  You’ll be shocked at what you find. And be humble. Humility will keep both me and all the other experts honest. What is wrong with saying I was wrong? Yes! I can say that!  I was wrong and be strong enough to know that I can handle that fact and still show up tomorrow for work! It’s OK to be wrong! Just try like mad to get it right the next time! It’s great to have experts around, don’t get me wrong. But let’s all take a step back and realize that we’re all human, we all have biases, let’s get them all out on the table and discuss. Let’s work on getting things right rather than protecting our turf for the good of everyone. 

 

Scott Hastings DO

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