The odds to becoming a doctor are incredibly low. Let’s take a look at the credentials required to become one:
- You need a bachelor’s degree (only 479 million people or 6.7% of the world population have one)
- You believe you’ll do well on the MCAT (86,181 people took the MCAT in 2011)
- You believe your GPA and MCAT scores are competitive (45,266 people applied to U.S. medical schools in 2012)
- You are accepted into an M.D. program (only 19,517 matriculated into a U.S. program in 2012)
While the figures in the list above don’t tell the whole story (people who delay or decide against medical school or those who pursue alternative pathways to practice in the U.S.), they give you a general idea of the selectivity surrounding the profession. Given this tough selection process, it’s no wonder why so many people assume that doctors are really smart; it’s pretty likely that they are smarter than the average person.
But how smart are doctors really? Doctors can’t possibly know everything about everything. It’s unreasonable, for example, to quiz them on how to rebuild the engine on your Volkswagen Jetta. Yet so many people trust doctors with non-medical related advice all the time. Pretty much anything that is said can be qualified if it is coming from a doctor.
But you my friend think critically and realize how audacious it is to believe everything a doctor says. How critical should you be though, when it comes to your doctor’s medical advice? The majority of people, 70%, trust the accuracy of their doctor’s advice without the need for additional research or opinions. That figure is especially surprising when as much as 42% of the public report having experience with doctors making diagnostic errors. The error rate is so high that the International Journal of Healthcare Management is labeling misdiagnosis an epidemic. And rightfully so, 220,000 Americans die each year from preventable harm due to medical errors (with some estimates reaching 400,000). To put that into context, doctors are killing 25 to 45 people every hour.
The fact of the matter is our knowledge of medicine and how we practice it is still fairly primitive. Doctors are human and humans are sometimes irrational decision makers who are prone to making mistakes. Adding to these limitations, there are few mechanisms to tackle issues that contribute to diagnostic errors. For one, the current culture at hospitals is to sweep mistakes under the rug, making it incredibly difficult to share and learn from them. Two, HIPAA regulations restrict access to medical records making it extremely difficult for the public to scrutinize. Three, very few hospitals will voluntarily publish or come forth with their error rates. The amalgamation of these problems, among others, leads to information asymmetry which leaves patients to either rely on geographic availability or word of mouth recommendations from friends, family, and insurance companies. This happens despite patients knowing what information should be most influential in their decision-making framework to choosing a healthcare provider.
While companies such as HealthGrades are hoping to solve the information asymmetry bit, current privacy regulations limit what they can do. Other attempts to eliminate the root causes of misdiagnosis are still challenging endeavors. To answer the question in the title, doctors are smart but not as smart (or competent) as you think they are. It is in your best interest to do your homework when you choose your doctor and vet his or her advice.
*For more reading, here is a behavioral economics approach to study potential root causes of medical errors by researching physician overconfidence and its influence on misdiagnosis drafted by my colleagues Rachelle Lee, Seungwook Moon, and myself Robin Kabir.