Add this to the perils of healthcare leadership - more information might make you dumber.
That's the warning Malcolm Gladwell offered Sunday night in his keynote address to approximately 4,500 attendees at the Medical Group Management Association's 2010 annual conference, which kicked off at the Ernest N. Morial Convention Center in New Orleans.
"What happens when leaders feel as though they have perfect information?" Gladwell asked. "It turns out that giving experts more data doesn't increase accuracy or improve their decisions. ... It only increases their confidence about their own decisions and leads to overconfidence."
Gladwell is the author of four books: "The Tipping Point: How Little Things Make a Big Difference," "Blink: The Power of Thinking Without Thinking," "Outliers: The Story of Success" - all of which were number one New York Times bestsellers - and "What the Dog Saw," his latest, which is a compilation of stories published in The New Yorker.
In his remarks, Gladwell contrasted the garden-variety type of errors made due to incompetence - a failure to do something, or know something, that leads to mistakes - with expert error, which he argued arises when an agent has plenty of data at hand, the best training and knowledge of applicable rules, and still makes a mistake.
He said psychologists have found "in study after study" that experts tend to overvalue marginal information, a miscalibration that damages decision-making and can produce huge negative impacts.
Two examples dominated the 45-minute talk: The 2007 Wall Street financial crisis and the Civil War battle of Chancellorsville.
At Chancellorsville, newly appointed Union General Joseph Hooker had Confederate General Robert E. Lee's troops outnumbered by a 2-1 margin, outgunned and boxed in. He used balloon reconnaissance to precisely scout Lee's positions and maneuvered his men to outflank the Confederate troops. So confident was Hooker in his superiority, Gladwell said, that he boasted on the eve of the battle, "God Almighty could not prevent my victory."
But while Hooker had the advantages of battlefield intelligence and numerical superiority, his overconfidence limited his ability to plan for contingencies – such as Lee's willingness to launch a surprise attack into the heart of Hooker's defenses. The result was a decisive Confederate victory.
Similarly, Gladwell claimed, the financial meltdown arose because the best and brightest minds of finance kept placing bigger and riskier bets, believing that they could overcome the odds with a combination of better data and technology. It was, he said, Wall Street's arrogance, its overestimation of its own capabilities that brought down billion-dollar banks and investment houses.
And what did this have to do with healthcare? Gladwell predicted that if healthcare reform in the United States failed in the next five to ten years, it wouldn't be due to incompetence. Instead, he told MGMA attendees to be on the lookout for expert errors and overconfidence, urging them to question their own assumptions and biases, and to be imaginative and open to all possibilities.