"Oh it's very simple. My secret had been I know what to ignore." - Francis Crick
"In the end, the hard decisions inescapably involve imponderables of intuition, prudence, and judgment." - John F. Kennedy
Important decisions require intuition. As with all tools, this comes with potential for massive value, but also with the risk of errors. This post details how to consider your own intuition when engaged with the healthcare system.
Why It Matters
How might we think about the role of intuition when making hard medical decisions—especially if we have little or no experience in this area?
First, it's critical to understand that risks of mis-applying intuitions to situations of this magnitude can be immense. Medical decisions should be thought of as one-way doors. No matter how seemingly inconsequential the decision, the potential for unexpected issues is always present.
So how do we involve ourselves effectively in medical decisions if we are not doctors, or even medically literate? Understand that not being a doctor does not disqualify our intuition! The key is to ask the right sets of questions, reducing the problem to one we are capable of reasoning about. We must know what to ignore, to distill the essence of the problem.
Here's How to Do This:
1. Understand the Situation and the Problem to Solve
Unless it's an elective surgery or similar, the doctor will likely present this to you. You'll also probably be given a set of options. While these may not be fully exhaustive, they should serve as a starting point.
2. Define What a Good Outcome Looks Like
This is something you must own. If this is an elective surgery, define the outcome you are looking for. This includes fully understanding the risks and benefits. What are the downsides if this treatment doesn't go well?
Define your values. Ask: what if this doesn't go as expected? Would I regret the decision or treatment I went through? Why?
Decide
Consider hard medical decisions as a multi-gated system:
- Rigorously analyze a situation, including outputting a logical decision.
- Gut-check by asking: how does this feel? If it feels good, aligning with intuition, then you're in good shape.
- If the decision doesn't feel good, go back and try to understand why.
- Run it through the system again and see if that fixed it.
Very often the rational decision doesn't align with intuition—at least on the first try. This is good! We have an opportunity to dig into this gap. The key is understanding the problem at a deeper level. Ask: why don't my brain and my gut align?
- Did the analysis miss something important?
- Would a negative outcome lead to regret? Did I mis-calibrate my risk tolerance?
- Is the doctor optimizing for something you don't care about?
This method refines the decision and gets you to a place that makes both rational sense and feels right.