Thin Slices, Intuition and Getting Sued for Medical Malpractice

Can people spot a surgeon who has been sued for medical malpractice, from one who has not been sued, just by listening to 2 10-second voice clips from two different patients? Can a mere 40 seconds of hearing a physician’s tone and language be any indication of their medical malpractice history? The answer is: Yes. How, you may ask? Intuition is the answer.

Many of you may have heard of Malcolm Gladwell’s book, Blink: The Power of Thinking Without Thinking, which is about personal intuition and how accurate it can be. His book was, in part, based on the work of Nalini Ambady, PhD who spent a large part of her (too short) career investigating and validating the notion of intuition based on “thin slices” of knowledge. Dr. Ambady coined the term “thin slices” to talk about brief observations people use to make snap judgements about everyday situations in life and how they are, often, very accurate.

One of Dr. Ambady’s most interesting studies (to us) was a study she published in the July 2002 issue of Surgery looking at surgeons and medical malpractice history. She examined whether or not strangers could tell which surgeons with histories of medical malpractice claims could be identified, based on their speech and tone (controlled for content), in routine conversations with patients. These brief, 40-second (in total) thin slices of audio were enough for subjects to successfully identify claims and no-claims surgeons.

So, what can we learn from these thin slices? How did surgeons who were likely to be sued for medical malpractice talk? See the paper for the entire discussion, but in short, physicians who spoke with dominance and a lack of anxiety were most likely to be sued for malpractice. The authors suggest that dominance and a lack of anxiety translates to a lack of empathy and concern. Thus, this type of doctor-patient communication may “set the stage” for a medical malpractice lawsuit, should an error occur or a poor interaction take place.

Clearly, “how” information is given may be as important as “what” information is given. Thus, never underestimate even the most brief of your encounters with patients.