Archive | January 2019

Oddly Asymmetric

Hi all, sorry for the silence but GG just managed to convert a ten-minute outpatient procedure into a month-long hospital stay. Which brings us to our topic today.

Go into just about any grocery store here in the U.S. and you can buy some kind of lottery ticket or scratch-off game or other form of gambling. And if you care, you can often find the odds of winning different prizes (e.g., at the bottom of this page). Needless to say, over the long haul, you will lose (state lotteries are a means of raising money) and the odds of hitting a big reward is usually tiny (below one in a million).  And yet lottery products are popular.

Now go in for virtually any procedure with a physician and you will be handed a page for you to sign saying that the risks of the procedure have been explained to you.  Those risks are often listed in a run-on sentence with increasingly distressing outcomes, nearly always ending with “death”. Now clearly you didn’t wander into the doctor’s office looking to end it all, so what is this “death” stuff? How often does that happen?

Since the form never (in GG’s experience) actually lists odds, all you can do is ask the physician.  How many times have you had this outcome? Out of how many procedures?You might be surprised to find that things going a bit off the tracks might be pretty common–way more common than winning those lottery games.  Few if any physicians would do a million procedures in their lives, so the really low probability events are hard to gauge. Depending on why you are there, you might decide that this procedure isn’t really worth it–but you’d have to ask. A truly rational assessment requires some work–and even then you might get misled by the small number of really bad outcomes. [GG managed a personal worst for the physician doing his outpatient procedure]. But most of us don’t do that–we go to the doctor to get better, that is the goal and our understanding, so the form is just a little piece of theater. [Something similar goes on with drug ads that show happy people enjoying life as a sotto voce voiceover lists the numerous potential side effects of the medicine being touted].

It seems on our own, relying on our gut rather than our minds, that we overvalue positive outcomes and undervalue negative ones. Something to keep in mind the next time you make a gut-level decision.