Being confronted with this situation recently (4 physicians, none of whom agreed on the appropriate course of action) caused me to reflect on decision factors to be considered when this happens. These issues seem applicable in comparable situations you may face:
- What are the experience levels among dissenting parties? Are they generalists and/or specialists?
- How long has each expert been involved with the situation? Does more tenure translate into greater expertise?
- Are there differences in the risk/benefit perspectives among the experts?
- Do any of the experts have a personal or vested interest in a particular outcome? Does a preference create disproportional bias on a particular expert’s perspective?
- Is there a more solid logic behind one point of view vs. another?
- How do the relationships among the experts play into the difference of opinion?
- How willing is each expert to consider and learn from new information?
- Are any experts in roles that create a disproportionate bias?
- If assistants are involved, how do they react relative to the experts they are or aren’t affiliated with?
In the situation I faced, it appears we made the right decision.
We took the most experienced expert’s point of view; he also had the most tenure and personal interest in the situation. The medical specialist, who was newest to the case and most reluctant to act, demonstrated role bias, made an illogical risk assessment, and had a wonderful P.A. who gave ample cues that she wasn’t fully in support of his position. He was willing, however, to accept new information, and went ahead with the (successful) surgery he was initially reluctant to perform.
So, what questions or criteria do you use to figure out which expert to believe? – Mike Brown
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