The Confidence Game: Too Little Confidence

Fifth Universal Definition of Myocardial Infarction

Finding the right level of confidence can be a lot like Goldilocks finding the right bed. I fear it’s much easier to have too much or too little confidence than to get it just right.  

Let’s start with the problem of too little confidence. Have you ever been in a situation where you observed something that bothered you, but you weren’t quite sure whether to say anything?  

I bet most of us have.  

In law school, I had a crazy experience with an individual who essentially threatened me in a class. He said that people (well, he used a different word!) like me were responsible for the world’s evil. 

It all seemed so surreal that I was inclined to just let it go. That was absolutely the wrong thing to do. It was only when my fellow classmates who witnessed the exchange (it happened during class!) said I had to speak up.

This will seem like a non-sequitur, but it is not. I highly recommend James Stewart’s book, The Blind Eye. It describes the story of a physician in Ohio who went through the peer review process several times because of unusual deaths for patients under his care. Many people thought something was wrong. But few spoke up. And it took quite a while before the system recognized that the physician was actually a serial killer.  

I’m often involved in peer review situations, and I readily admit that if I had been part of that investigation, I likely would have dismissed the idea that the physician was intentionally overdosing patients. Those who suspected something was wrong were understandably hesitant to speak up; falsely accusing someone of murder is a serious matter. Although I first framed the problem as a lack of confidence by those who stayed silent, it can also be seen as overconfidence by those who dismissed the concerns that were raised. When someone questions another person’s conduct and I immediately reject the concern as unfounded, I may be placing too much confidence in my own judgment.

Finding that magical line where you have just the right amount of trust in your judgment is incredibly difficult. But it’s also remarkably important.  

I don’t have a magic answer on the best way to solve this problem, but I think one strategy is to brainstorm with others routinely, keeping a very open mind and refraining from criticizing or teasing others as they consider your position. When something seems a bit off to you, if you talk with a colleague and they share the concern, it will be a lot easier to raise it, and you’ll likely do so with more assertiveness. And when a colleague comes to you with a concern, be sure to seriously consider it, even if your initial thought is “this is crazy.” 

Carefully discussing the concern with a third party reduces the risk of being either too cautious or too dismissive.

EDITOR’S NOTE:

The opinions expressed in this article are solely those of the author and do not necessarily represent the views or opinions of MedLearn Media. We provide a platform for diverse perspectives, but the content and opinions expressed herein are the author’s own. MedLearn Media does not endorse or guarantee the accuracy of the information presented. Readers are encouraged to critically evaluate the content and conduct their own research. Any actions taken based on this article are at the reader’s own discretion.

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David M. Glaser, Esq.

David M. Glaser is a shareholder in Fredrikson & Byron's Health Law Group. David assists clinics, hospitals, and other health care entities negotiate the maze of healthcare regulations, providing advice about risk management, reimbursement, and business planning issues. He has considerable experience in healthcare regulation and litigation, including compliance, criminal and civil fraud investigations, and reimbursement disputes. David's goal is to explain the government's enforcement position, and to analyze whether this position is supported by the law or represents government overreaching. David is a member of the RACmonitor editorial board and is a popular guest on Monitor Mondays.

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