The Undoing Project: A Friendship That Changed Our Minds

by Michael Lewis

But then UCLA sent back the analyzed data, and the story became unsettling. (Goldberg described the results as “generally terrifying.”) In the first place, the simple model that the researchers had created as their starting point for understanding how doctors rendered their diagnoses proved to be extremely good at predicting the doctors’ diagnoses. The doctors might want to believe that their thought processes were subtle and complicated, but a simple model captured these perfectly well. That did not mean that their thinking was necessarily simple, only that it could be captured by a simple model. More surprisingly, the doctors’ diagnoses were all over the map: The experts didn’t agree with each other. Even more surprisingly, when presented with duplicates of the same ulcer, every doctor had contradicted himself and rendered more than one diagnosis: These doctors apparently could not even agree with themselves. “These findings suggest that diagnostic agreement in clinical medicine may not be much greater than that found in clinical psychology—some food for thought during your next visit to the family doctor,” wrote Goldberg. If the doctors disagreed among themselves, they of course couldn’t all be right—and they weren’t. The researchers then repeated the experiment with clinical psychologists and psychiatrists, who gave them the list of factors they considered when deciding whether it was safe to release a patient from a psychiatric hospital. Once again, the experts were a...