The most striking thing from the book are the sections on confidence. By acting confident in your abilities and predictions, people's confidence in you goes way up. If you hedge your predictions, act uncertain at all, or consult reference material - their confidence in you goes down, and satisfaction in your performance also goes down.
So what's the problem? Well, the scariest part for me was talking about doctors. They set up an experiment where they filmed two actors playing a doctor and a patient.
The patient was asking the doctor about getting antibiotics prescribed before a dental procedure, which might or might be necessary and helpful. They presented one of three scenarios to viewers and asked them to rate the doctor and how satisfied they'd be with the doctor:
Scenario #1: The doctor prescribes the antibiotics confidently, with no hedging or uncertainty.
Scenario #2: The doctor says, "I'm not sure if these are really necessary... but what the heck, there's no harm" and prescribes the antibiotics.
Scenario #3: The doctor consults a reference medical book to get numbers and clinical results in front of the patient to be sure it's really necessary, and then prescribes.
What's scary is that the scenario #3 doctor was given the lowest ratings on performance, even lower than "what the heck, there's no harm" cavalier attitude. But the authors noted that in real life, it's the most skilled and thoughtful doctors who question their own judgment and are willing to check reference materials to make sure they're doing right by their patients.
The book provided similar examples in other fields, including the judicial system and academia. Confident people are believed much more often. Estimating the chances you're wrong, admitting you might not be correct, or consulting reference material lowers people's belief in you and their satisfaction in your performance.
This is a huge, nasty conflict of interest. If you want people to believe you, you should use raw confidence, you should refrain from hedging your predictions or admitting you might be wrong, and you shouldn't publicly consult reference material in a case where you might have incomplete information.
Of course, that's pretty much the opposite of what you should do if you're looking to maximize the chance of a correct outcome. Some reasonable self-scrutiny, estimating the odds your prediction is wrong, and checking reference materials are all likely to make you more correct.
So there's a big conflict of interest here - people will be most satisfied with your performance if you admit no chance of error and consult no outside materials. On the other hand, this makes you more likely to make block-headed mistakes. Discuss.
Fascinating read. This is particularly interesting coming from the legal world. At the higher end, where I've worked, problems don't often have easy answers because they've never happened before. The only thing you can truthfully tell a client is: "I don't know. It should come out this way, but there's no precedent because this hasn't happened before." That doesn't exactly brim with confidence.
Most of the people I've worked with are long-time clients, so they are used to this going in, and have experienced these situations turning out well, but this could definitely turn off prospective clients. Still, carefully explaining your position is better, in my view, than expressing super confidence, which can open you up to malpractice suits...
Kate's quite correct, if you are hired as a knowledge professional - consulting the manual implies that your knowledge is incomplete. Of course it is impossible to have a truly encyclopaedic knowledge of anything, but keeping people's faith in your ability does require the illusion of it at least.
I usually avoid consulting a manual in front of anyone, it does spoil the illusion that you are in complete command of all the facts at all times. The trick I use when I absolutely have to consult a manual in front of a customer (or even a colleague) is that I'll preface it with a comment to the effect that the problem we are dealing with is not conforming to what the manual says... it's therefore not a problem due to my lack of understanding, but a problem with the manual I need to check. This also implies that I have a clear memory of all the manual's contents and even that I know the system better than the manual! The second trick, even when the manual tells you that you were flat wrong in what you previously said, is to say "Ah yes, I thought so..." before explaining what you have found in the reference material.
If I need to rely on somebody else's help, I might have nothing to go by except for social cues when it comes to judging their skills. There are wonder healers who make loads of money by just pretending to have the skills to help you (e.g. Peter Popoff). That's why it is so important to raise the general level of education.
I'm a veterinarian and I find this to be completely true in practice. I think people want to be able to have an almost god-like faith in your abilities. Sometimes what people are asking you to do is make the decision for them - that is why they are paying you, that it why they came for your advice. It can be hard to explain to someone with a very different educational background that a dry reference book would not necessarily be able to inform decision making if you didn't already have a broad understanding. It can be helpful and supportive to present a confident exterior (confident in the notion that it is up to you, rather than in the idea that you know everything) and consult with colleagues/reference manuals in private rather than in front of an anxious client. Sometimes the most professional thing to do is not force the client to watch the process but just explain the outcome clearly and confidently.
Joe's right that trust is the key factor here. Since the observers rating the 'doctor' had never seen him before, they had no history on which to base their trust, so the gap is filled by whatever cues are available. Observing a high degree of confidence in the doctors actions strongly suggests competence. As a patient gains experience with the outcomes of the doctor's consultations, they increasingly base their trust on these and observations such as the above become progressively less significant.
Also, I suspect the trial here was influenced by the trivial nature of the patients request. Whether or not antibiotics are advised before seeing a dentist is something that most would expect a competent doctor to just know, and needing a reference book is legitimately a sign of inexperience or incompetence. If the patients complaint were more complex, the reverse would likely be the case, and giving an immediate response, however confidently, would be perceived as cavalier.
I don't see the concern here.
When the doctor prescribes the antibiotics without a visible doubt, the patient assumes he knows the reference book. If the doctor admits some uncertainty, the patient assumes he understands the nuances of the situation, lending credence to his prescription. Only in the last scenario, when the doctor has a book as a crutch, does the patient have reasonable fear: if my diagnosis is as simple as looking up in a reference book, why am I not the doctor?
I understand this heuristic allows for an irrational exception, where the overly confident doctor receives higher marks. But how often does this happen, really?
That's not the full story.
It's more than satisfaction. It's trust. Expertise. It's knowing you made the right choice by going to the person.
At surface level, it's exactly like the book describes. People are attracted to confidence. But that doesn't last forever. If you're a doctor and you never have a repeat patient, then yes, you should take full advantage of the act. Why? You want people to be satisfied. You can do the double-checking behind the curtain later on. Then you can make a correction, showing just as much confidence as before. (And I wonder. Would admitting your fault also lower satisfaction? If so, you could blame something external. You'll never see them again, and more importantly, you'll still leave them feeling satisfied. This needs a separate experiment though.)
On the other hand, if you're surrounded by competence, the act won't last long. Eventually word leaks out. Somebody became ill. Another never feels good anymore. Patients will know. You'll initially have their trust, but that will fade. And trust is a tricky thing to get back. This is where being a careful doctor ultimately wins. You'll gain a reputation. And new patients will trust you because they've confidently been told they could. Let me say that another way: the confidence comes from others, instead of you, that leave new patients feeling satisfied.
Some good replies to the post "Conflict of Interest: On Confidence, and Confidence."
One of things that stood out to me is how a couple commenters assumed that because they're reasonable, other people should also be reasonable. I mean, if a doctor checks something carefully in a reference book in front of me, I think that's a good thing. You probably do too.
But many people don't think that way.
A lot of people have unrealistic expectations of the world, especially of professionals like doctors.
There was a brilliant comment by Kate Johnson, who is a veterinarian. Kate writes -
In a reply to a reader, I found myself elaborating on things about Vitamin D3 that I didn't go into in my post. My answer is a bit tinged by my own worldview, a bit off-topic (surprise!), and opinions are solely my own, but don't let that dissuade you from doing your research into this powerful vitamin.
Glad to meet a fellow D-bomber who doesn't parrot the party line of kidney damage (which happens with non D3 types). I've only taken 4,000-8,000 IU for about 3 years (depending on if I forget to take that 2nd one per day) with no supplemental sunlight and last I tested my levels were only at 55 I think. I use Carlson's Vitamin D 4.000 IU Cod liver oil gelcaps. After seeing your dose I definitely have to up a notch :D. It's funny but anything over 20 or 30 I think in the 'conventional' medical paradigm worries the docs who aren't in on the benefits of D3. They always tell me of kidney damage and that one new england milk study (which used d2 instead of d3). I'm not immortal but ever since I've started C-D bombing as I call it (1-2k grams Vit C per day and 4-8k IU Vit D per day and maybe triple that when sick) I have only gotten sick once a year or so if even that. Now doing some no/low carb action to supplement that been feeling great so far - recovered from near metabolic syndrome myself.
W-in-H: D-bombing is a most fitting descriptive :) It's heartening to meet another soldier that has seen beyond the entrenched view on recommended Vitamin D3 doses.
D FOR DISRUPTOR
Don't get me started on the establishment. They're dogged by super-slow regulatory processes, research bias, and a legal minefield around consumer protection (that last one we need, without the mission creep). To that, add the preventative nature of D3, the fact that it's not Rx, and all those faulty studies, and I'm not surprised they'd shirk at recommending higher doses. They're also liable if their recs go wrong, so why mess it?