We Don't Know as Much as we Think

The Dunning-Kruger Effect Affects us All.

Photo by Markus Winkler on Unsplash

Physicians often talk about the “The Dunning-Kruger Effect.” And honestly, I get tired of hearing about it.

To make things easier let’s just call it the DKE. The DKE is defined, in an article by Psychology Today, as follows:

The Dunning-Kruger effect is a cognitive bias in which people wrongly overestimate their knowledge or ability in a specific area. This tends to occur because a lack of self-awareness prevents them from accurately assessing their own skills.

https://www.psychologytoday.com/us/basics/dunning-kruger-effect

Medical professionals and public health experts tended to talk about this a good bit during the pandemic. And they had some good reasons. I encountered a bit of it in my work during that dark tim

.

I well remember a very obese young man, well educated, who was short of breath with dangerously low oxygen levels. He was positive for COVID-19, and was at a high risk for deterioration. But he yelled at our ER team because he insisted that COVID didn’t even exist.

There were all kinds of ideas floating around then; some due to suspicion over government motives (and pretty poor messaging all around), much due to the sharp political divide we had fallen into, some from charlatans trying to make a buck on products. It was easy enough to say that a lot of people suffered from the DKE because they denied what experts said and weren’t educated about medicine, virology, public health, vaccinations or whatever you like. It was a problem.

In fact, most of us in medicine encounter this on a regular basis. People insist on certain radiology scans, or perhaps antibiotics, despite our informed explanations that they aren’t indicated or necessary. They tell us that they know what they need and we don’t. That their family member, tangentially involved in healthcare, insists. Or that their understanding of a medical condition is sufficient because it comes straight from a web search.

This can be really frustrating to physicians, nurses and everyone else. It’s easy, over time, to become snarky. To look down our medical noses at the “uneducated masses.”

It’s ironic because in fact, our patients are sometimes right. Or their reasons for listening to us, or not, are more valid (or at least explicable) than we first realized. A good example is when patients with many tattoos insist that they can’t endure IV sticks. Turns out, some of them likely have a history of sexual abuse which makes every painful procedure more painful.

I suppose we’re all afflicted with some degree of the DKE. No matter what our profession or trade, no matter our station in life, our knowledge is necessarily limited. However, many times those with more advanced degrees are particularly susceptible to the belief that they know best, simply by virtue of their intense knowledge of a particular subject. For instance, a PhD in economics or cellular biology is a fine thing. But it doesn’t make one an expert in religion, automobile repair, law enforcement or farming. My Uncle Darrell was a brilliant, widely published geologist. But I wouldn’t have let him diagnose my heart attack. Or build my house. May he rest in peace.

I think this was why the pandemic response went badly. For instance, many in medicine and public health, and especially those in what has been (rightly) termed ‘the laptop class,’ saw lock-downs as wise, cautious and safe. On the surface it made some sense.

What they didn’t understand was that vast numbers of people just couldn’t stay home. While a lot of those in favor of lock-downs could typically stay home, financially and logistically, it wasn’t the case for all.

Many of those opposed had jobs, or financial conditions, which required that they be physically at work. And we’re certainly glad that many of them were! They trudged out into the scary, virus haunted world and made products like masks, gloves and medications. They drove ambulances. They fought fires. They fought terrorists. They arrested criminals. They grew food, cooked food and (to the delight of those reveling in the lock-down) they went outside and delivered food. They kept Internet connections running by maintaining cables and satellites. They produced electricity. They managed sewers, trash and water. They cleaned buildings. They worked on cars.

It was extraordinarily short-sighted to assume that everyone could luxuriate in a life at home, watching Netflix and eating Door-Dash Orange Chicken. This was Dunning-Kruger at its finest. And it was especially cruel to the poor.

The same was true of school shutdowns. Children with parents who couldn’t stay home were unsupervised and certainly didn’t have the privilege of the sudden validation of home-schooling. They might have had state-supplied tablets, but they might not have had reliable Internet. They had remote teachers, but nobody at home able to help them; or in some cases willing.

Others were abused. The teachers who might have filed reports with DSS couldn’t see them. The DSS workers couldn’t visit them. A lot of kids fell out of the educational system, or at least lost a couple of years of learning.

I’m not trying to focus only on COVID. It was a terrifying and confusing time, and I believe that the majority of the people who were trying to make decisions were trying in good faith. They just didn’t realize what they didn’t know. Clearly we all have lessons to learn.

It goes on, though, this DKE phenomenon (or some variation on it). We continue to suffer from a ‘wrong overestimation of our knowledge or ability in specific areas.’ It happens when those who can afford college suggest that college is the only proper path for young people, despite the debt it incurs and for many degrees, the low return on investment. Compared, for example, with a valuable trade.

DKE is evident when policy makers pass regulations which leave the poor struggling to afford heat and energy, limiting the production of electricity by affordable, consistent means in the hope that all of it can come, cheaply, from wind and solar. The same when policy-makers think that before long, everyone can afford a $40,000 electric vehicle and the electricity to run it, when many can barely afford the $500, 20-year-old vehicle that takes them (most days) to work and home. We live in a world where a $500 dollar car would be an immense luxury for most of the people on earth.

We even seem to have a kind of Dunning-Kruger Effect when it comes to the past. C.S. Lewis called this ‘chronological snobbery.’ He defined it as ‘"the uncritical acceptance of the intellectual climate of our own age and the assumption that whatever has gone out of date is on that count discredited."

We tend to assume that the ideas of our ancestors are antiquated and in constant need of a good dismantling. A great example of this is the idea of a two parent family. So many children today do not have the privilege of both mother and father at home. So many experts and policy makers, pundits and activists insist that this is just fine. And yet, recent scholarship seems to suggest that in general, having two parents at home is better for children. Not that single parents can’t be amazing, or can even exert control over their situations, but on the balance two is better than one.

Even our ancient tendency to worship can suffer from this same snobbery, this same DKE. It occurs when moderns who are highly educated and well off, with food, jobs, health and connections, suggest to the poor and desperate that they abandon religious faith, the faith of their ancestors for perhaps thousands of years.

They tell them it is old and irrelevant, unscientific and ridiculous. More, they suggest that believers should just trust reason and enjoy this amazing life of health and modern wonders. However, for most people on earth this remains a difficult, hungry, thirsty, sick, violent life for which the hope of life after death, the belief that suffering has meaning, is extraordinarily rational. And is often the only profound source of comfort available to them. (This is not a reality confined to the poor; the well-to-do can also lead lives of depression and desperation as well. They simply anesthetize it with the trappings of comfort. Everyone can benefit from the transcendent meaning and hope of religious faith which we are so often compelled to dismiss. And which our ancestors understood quite well.)

Speaking of faith, even our faith in science is subject to the Dunning-Kruger Effect. That is, maybe we don’t know as much about science and its reliability as we thought. This isn’t to say we should reject it, repudiate scientists, or that their work isn’t valuable for certainly it is. Without science our lives would be far less comfortable and healthy.

But it has been increasingly noted that there is a ‘replication crisis’ in science. That is, research studies are done, reported and sometimes acted upon. But when the same studies are repeated, the outcomes are different. Maybe the finding wasn’t true after all! All too many studies are poorly done, and produced for the purpose of maintaining academic positions. Or are done by industry for the purpose of marketing valuable products. We have always known that this is a problem in the pharmaceutical world.

The website 'Retraction Watch’ has interesting data on studies that are released but then have to be retracted for a variety of reasons.

https://retractionwatch.com/

Maybe these aren’t all perfect examples of the Dunning-Kruger Effect. I’m not a psychologist or cognitive researcher. I’m a physician and a writer. A husband and a father. However, as wonderful as those credentials are, they don’t make me an expert in most of what goes on in the world, or has gone on in history. They certainly don’t make me an expert in the DKE!

I try to be careful about the opinions I express. (Certainly more careful than when I was younger.) I want to be charitable to all of those who make mistakes in their thoughts and words, whether scientist or lay-person and no matter their political or cultural inclinations.

I just think that we all need a big dose of humility about everything outside our own understanding and experience.

And a bigger dose of grace towards everyone else who, while not experts in our fields, are probably pretty smart about something else.

The fact is, we have all met Dunning-Kruger.

And it is us.