I’m taking a course right now on decision-making in medicine. As a doctor, I make decisions every day on matters both minor (next appointment in three months or four?) and major (open-heart surgery or just another pill?), but medical schools generally do not require a course on the science of decisions. And yes, there is a science to it. There’s even a group of scientists focused on this issue, the Society for Medical Decision Making.
Human beings often neglect to fully evaluate the risks and rewards of a given situation. For instance, if I tell you that I have a medicine that will save 200 of 600 people infected with a deadly virus, you’ll respond differently than if I tell you that I can medicate 600 people who have a deadly virus and yet 400 of them will still die. The numbers are the same; the presentation is different.
Similarly I might tell you that a proposed surgery has a 5% risk of complications. Or I might tell you that a proposed surgery has a 2% risk of death, a 2% risk of leading to loss of a limb, and a 1% risk of a serious blood clot. That adds up to 5%, but it sounds a lot worse. Daniel Kahneman, the psychologist, who (along with his collaborator Amos Twersky) described these biases, won a Nobel prize in 2002 for the work.
Remember, doctors are human beings too. That means that we are subject to all these biases and miscalculations. We must try to see each situation from every angle. Maybe a course on decision-making is something doctors and patients alike should take before we head to the hospital ward.
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