Contrary to popular opinion, it’s not a weakness.
By Paul Cerrato, MA, senior research analyst and communications specialist and John Halamka, M.D., Diercks President, Mayo Clinic Platform
The history books are filled with discoveries and inventions by brilliant men and women—visionaries who were able to see what the rest of us “mere mortals” could not. Many of these scientists and clinicians had the self-confidence to develop invaluable tools that moved the human race forward. But a closer look at these great minds reveals some were nonetheless tarnished by serious flaws in judgement. They allowed their accomplishments to cloud their thinking, convincing themselves that they were infallible. This dichotomy begs the question: How does one find the balance between self-confidence and hubris?
While a lack of self-confidence can paralyze a clinician, the other extreme is just as harmful. Humility strikes a balance between the two. Humility enables one to sidestep arrogance; and having a healthy sense of self-esteem enables one to practice such humility because it provides one with the emotional security to say: I was wrong on that point. Arrogance, on the other hand, can prevent someone from recognizing a better solution to a problem because it offends their ego or embarrasses them. One research group described the problem this way:
“The risk of hubris affects politicians, leaders in business, scientists, academia, the military, entertainers, athletes and doctors (among many others). Power, especially absolute and unchecked power, is intoxicating and is manifested behaviourally in a variety of ways, ranging from amplified cognitive functions to lack of inhibition, poor judgment, extreme narcissism, deviant behaviour, and even cruelty. Hubristic behaviour of overconfidence, extreme pride together with an unwillingness to disregard advice makes powerful people in leadership positions to over-reach themselves with negative consequences for themselves and others.”
How exactly might arrogance affect physicians? Consider the evidence. A systematic review on the impact of cognitive biases on medical decisions found that at least one cognitive bias or personality trait affected physicians’ behavior. Overconfidence, lower tolerance to risk, as well as information and availability biases were linked to diagnostic inaccuracies in 36.5 to 77% of case scenarios studied. Similarly, a Japanese survey that asked emergency department physicians to describe their most memorable diagnostic errors included 387 physicians, who said overconfidence was their most common shortcoming. The researchers also found: “A comparison of the initial and final diagnoses of cases with diagnostic errors shows that there were more cases with diagnostic errors caused by overlooking another disease in the same organ or a disease in a closely related organ.”
There may not be a precise mathematical equation or metric to help us find the balance between self-confidence and arrogance, but the evidence suggests humility and a healthy dose of self-esteem are the keys to finding that balance.
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