Identifying and selecting the expert
If you developed a rare and complex medical condition, such as autoimmune myasthenia gravis, it would be important to find the right expert to treat that condition. Why? Because you’d want to be cured of the condition, or maximise your life-expectancy with a reasonable quality of life (if it is not curable). Most people with such a condition – I could imagine – won’t be seeking the advice of their local pharmacist, about what pill to take for the condition.
The diagnosis of the condition would probably have been made by a doctor – but let’s say that doctor does not have the right level of expertise to treat the condition. You may then be referred to an expert who can treat the condition. Immediately one can see that the skill of ‘diagnosing‘ could be different to the skill of ‘treating‘. It’s like a burst pipe in your home. You have the expertise to say ‘it’s a burst pipe‘ but you do not have what it takes to fix it.
A disclaimer at the end applies.
Whilst doctors may be considered experts relative to people who are not doctors, there will be different levels of expertise among doctors. Some doctors will have specialised in a particular area of medicine e.g. endocrinology, immune disorders, gynaecology, mental health disorders – and so on. So – you’re not going to consult a psychiatrist if you have a serious bowel disease. It’s that simple. Knowledge and experience in an area of specialisation emerge as qualities of experts.
People normally seek out experts when there is a particularly difficult situation that needs managing, fixing or gaining some advantageous insight. The triad of knowledge, skill and experience (KSE) is important in defining the expert. Academics my have lots of knowledge about a particular topic but they may lack skill and experience in complex situations.
Skill is something acquired through training and practice.. It is a very practical thing that depends on experience. Knowledge does not provide skill.
Novices and trainees may have KSE too. The issue becomes a matter of the degree of that overall KSE. The Dreyfus model is useful in understanding the route from novice to expert. [All diagrams are clickable for a larger view]
Not unusually, some of the very best experts do not carry around a whole lot of broad knowledge in their heads (though some will). For those experts who are not ‘walking encyclopaedias’, what differentiates them is having a very deep understanding of a large body of knowledge which cannot be recited at a moment’s notice. By way of analogy, that understanding is likened to a fine piece of cloth i.e. the individual threads composing it are difficult to pick out. The vast body of knowledge is fluid and used creatively, along with skill and experience. But those experts will know how to recover or find facts that they once had at their finger tips. A proper expert will of course be expected to carry a lot of knowledge of an individual case s/he is contracted for (but may not carry an ‘encyclopaedia’ of broad knowledge).
Command of KSE therefore becomes important. An expert who recites chapter and verse on a particular topic may appear impressive – but the big issue is ‘can they use it to create advantage?‘. This is not about scoring high in an examination or test. Your chosen expert doesn’t get marks in court for how many facts they know. An expert is there to serve the court, with carefully reasoned opinion evidence (a special thing). This is about how the expert marshals their thinking about facts.
Notice that ‘creativity‘ comes into the ‘equation’ in understanding the expertise of an expert in the Dreyfus model (see diagram). Two experts can look at the same body of facts yet one may fail to unearth some important meaning. Creativity is that special ability to look at situations and find something novel, that nobody else saw before. This is not about creating something out of nothing. It is about unearthing something truly valuable when it was buried in a mishmash of complex information.
How do you know if your candidate expert has such a quality? You can only do that through conversation – not emails. That’s why it becomes important to see and talk to your candidate.
Some definitions of expertise rely heavily on a track record of successes. An expert with a 75% success in some area may appear better than one who has only 50%. It kinda makes sense as nobody likes to bet on a horse with a bad record. But this is not horse racing. Success rates of an expert may not reveal that they have deselected cases where chances of failure are too high for their liking. Or it could be that by happenstance, an expert has taken cases largely from a bunch of lawyers with a low threshold for failure. It is possible that an expert with 50% successes may not have cherry picked better cases. Success rates can give an inflated appearance of expertise or give the appearance of lesser expertise.
The following are suggested as good characteristics:
- They are good listeners.
- They live close to reality.
- Not afraid to be challenged and alter their opinion when confronted with new robust evidence.
- They are not afraid to displease by voicing their perception of reality, which may often differ from a majority of people.
- They are not overly occupied with convincing anyone about some point.
- They understand the limitations of evidence.
- Often times they work in complex areas where hard evidence is not available.
- Their thinking and reasoning skills stand out.
- They are very capable of self-correcting.
- They are cautious not to exceed their competence, or expertise.
Cost – usually the biggest issue is left for last. As with many things, too cheap is not good, and too costly is not cost-effective. Pay with peanuts and you attract monkeys – as the saying goes. But then there is no point purchasing a Bentley if the job can be done with a Fiat. The following factors are suggested in assessing how much one wants to pay within a budget:
- Likely quality of the report. Why not ask your expert for well redacted samples of previous reports (cases that are not live)? A sound expert will have these ready.
- Quality of the expert. Qualifications count but it is not the biggest factor. It is is a human factor. Talk to your expert by phone or in person. Professorial Goliaths do get taken down in court by judges and ‘Davids’.
- Complexity and intricacy of the case. A preliminary discussion of the case can bring out if your candidate expert picks up on the core issues and whether they ask sound questions. In other words from among a tangled mess of complex issues can they spot the big issues.
Let’s say you have contracted some ghastly illness, and you’re not impressed with the way a public health service has treated you. So, you decide to go private. Recommendations from friends, family and reputable websites can be useful but also misleading.
Much of the above considerations about experts for court, can be useful. Importantly though this is about getting the right treatment or surgery. It remains important to talk to your expert, preferably in live face-to-face conversation in a true (not virtual) space. If that’s not possible then good quality video conferencing.
Many good experts will offer an initial consultation for a fee. This is fair enough because their time is valuable and they wouldn’t want to be called by umpteen people who are just fishing around, for a bit of free advice.
A sound medical expert will not be hungry for your money. They will demonstrate many of the cognitive and psychological characteristics outlined above. They will be concerned about your health and trying to ensure that they can do the best for you within their level of expertise.
Sound experts will be very transparent about their fees and what they aim to deliver.
In this sort of scenario reputation of clinics or groups of practitioners will be of value. Good experts flourish in good teams.
Selecting the right expert for a job is not easy. Careful investment of time researching the expert and talking with them will make for a better selection process. Understanding how KSE operates for experts is useful. Track records can be misleading. Better experts tend to flourish in high quality groups but there are good experts who function very well working alone. Cost is a difficult area to assess. In general too cheap means not too good.
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