Monday, November 27, 2017

Experience and Intuition

A few weeks ago I had to go to a doctor for a small orthopaedic condition.

I went to the doctor. A junior doctor heard me out, examined me - made me do a series of movements with my arm, asked me to take a <machine test>. Armed with the report, I went to the main doctor who in turn read the report (all normal) and the diagnosis for 30 seconds and sent me packing with some medication and said I might have to come back for some physiotherapy. For a week, nothing happened - the pain came back after the course and no discernible improvement for another week after that and then I decided to to take a second opinion.

The second doctor heard me out. He glanced through the report. And made me do a series of movements with the arm. He also gave me a couple of tests to do to check for secondary indicators. And thats it. He had identified my condition- gave it a name. He put me on a physiotherapy regimen for 6 weeks. He said there was no need for any further machine tests of any nature - unless I show no improvement in the next few weeks of physiotherapy.

What was the difference? If you notice, the sequence was pretty much the same. Not very different.

The second doctor was as experienced as the first doctor. Both these highly experienced doctors work in big reputed insitutions - so this story is not about the big Goliath being trounced by the small David.

The difference:

One was short term versus long term. The second doctor gave a name for the condition, a name for the physiotherapy regimen and no medication for the immediate pain (it was not a lot in the first place). He also gave me a set of tests to do to identify if this was a leading indicator for something and said if these show up as abnormal - you are into something serious. The first doctor game me an anti-inflamatory course and said you may have me to do some physio as an afterthought - which did not sound very convincing to him - and also to me.

The second doctor created a sense of urgency in me - and got me going instead of treating it as a short term condition - he got me going for the long term.

Also, in the second case, the basic diagnosis was done by the senior doctor - and it took him no more than 5 minutes. But armed with deeper experience he was able to cut to the chase better. And that is intuition - your ability to get to a deeper diagnosis/solution with the same set of data. The junior doctor needed a machine to let him know what was wrong - and the machine could not find out what was wrong - the second doctor told me that this condition cannot be diagnosed by that machine unless it is really bad.

This was the crucial difference in my view. The ability to intuit with the data comes with experience, not lack of it.

We often confuse intuition as a bolt from the blue in which someone wakes up and solves a nuclear physics problem. What we forget is that this intuition comes from deep knowledge and experience and still being able to listen to what the diagnosis is saying - especially when it is not black and white, but grey. Just having the machines, the certifications and the experience is not enough...

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