How (Un)Ethical Are you ….&… Why Good Accountants do Bad Audits…
Dear CSS Colleagues:
Enclosed are two articles very much relevant to our role as physicians and surgeons.
In the first article the authors note that “Most of us believe that we are ethical and unbiased”, but many factors actually make this unlikely if not impossible. While Conflict of Interest (COI) is handled differently in CME courses, and in our own institutions when it comes to research, Conflict of Bias (COB) and COE (Conflict of Ego) are unaccounted for. The authors consider the latter but not the former. I suggest that COE plays a real role in how we present our arguments. For example, we often see presentations about which operation is better for a given problem and why our research is better than that of the next speaker. I’ll say more on this in another post.
While implicit bias may play a role in our judgement relative to selection of one candidate over another when hiring for a position in our organization, it also affects how we listen to coworkers and colleagues. An example might be hospital administrators who listen to one another when making decisions rather than to the end-users (the physicians) of their organization. Such bias also affects our perception of how much we contribute to a workgroup or other collaboration, as we always tend to overestimate our value in projects and collaborative groups.
Being aware of such unconscious biases and our unconscious tendencies is essential to a balanced leadership approach and getting the best effort out of all in your group. It was Harry Truman who said, “You can achieve great things if you don’t care who gets the credit.”
In the second article , “Why Good Accountants do Bad Audits” I can draw many parallels to what we, as physicians, do relative to our patients care and our research. In research, unconscious bias can lead to over-stating positive outcomes in a retrospective study. Mohit Bandari has shown that in such studies the reproducibility of the results by a similar study is only 25%. While not all of this is due to bias (implicit or confirmation bias), it plays an important role.
How many times have you watched a presentation by a researcher at a national meeting and wondered “how does he/she get such great results?” The authors of the second article state “When we are motivated to reach a particular conclusion, we usually do.” The authors term this “self-serving bias.” Furthermore, just as accountants have an incentive to give good news to their clients, the same goes for researchers who need to publish, and good results are generally more easily published than bad results. Finally, just as it is difficult to tell if an error in accounting is due to bias or corruption, it is difficult to say the same for researchers whose results seem too good to be true.
I hope you find these articles of interest. If you have comments or criticisms, please post these to our Codman WhatsApp group as I will post this there as well.
“JP” Warner MD
Founder, The CSS