Wednesday, January 18, 2012
Eight-nine readers responded to the poll. The poll makes no claim to scientific validity, but I know you’re sure as hell interested in the answers ...
The major finding: 32 percent of you - nearly one in three - thought that more than two-thirds of psychiatrists were incompetent. One in five of you (19 percent) pegged psychiatric incompetence in the 51 percent- 66 percent range (more than half, up to two-thirds).
So - more than half of you think that more than half of psychiatrists are incompetent.
Over on the other end of the scale, just one in four of you (25 percent) thought that a third or less of psychiatrists were incompetent. Only one third of this twenty-five percent (less than one in ten overall) regarded ten percent or less of psychiatrists in the incompetent range. One in five overall (19 percent) responded in the one-third or more to one-half incompetence range.
Okay, how much incompetence in the field are we willing to tolerate? One-third? How comfortable would you feel about boarding a flight if you thought one-third of the pilots were incompetent? How about another branch of medicine, say brain surgery? Nope - doesn’t cut it. Neither does 10 percent, nor, for that matter, does one percent.
So here is what I hear you saying: Three-quarters of you (75 percent) are telling me that you think that a full one-third or more of the people we entrust our lives to have no business practicing psychiatry. More than nine in ten of you (92 percent) are telling me that you think at least one in ten psychiatrists is incompetent.
Mind you, this poll is about your perceptions rather than reality, but your perceptions are what’s important. And if your views are even the slightest bit representative of a wider patient-family member population, then - truly - interventions of biblical dimensions are called for.
Before we get carried away, the practice of psychiatry hardly lends itself to objective judging criteria. In my own field of journalism, a 2010 Gallup Poll reports that only 25 percent of the American public has confidence in newspapers and only 22 percent in television news. (I’m not sure which is the more frightening interpretation - that so many have lost confidence in my profession or that an uncomfortably high percentage of the public actually believes the crap they come across in the media.)
Thus, to be fair to psychiatry, any discipline that operates in the subjective realm is bound to draw a lot of heat, justified or not.
But there is another factor involved: Most incompetent people do not know they are incompetent. A 2000 NY Times article cites research in support of the proposition that the incompetent lack the skills to monitor and evaluate their own performance, thereby perpetuating their clueless behavior.
Research shows that the vast majority of people rate themselves as “above average” across a broad band of abilities. In one study that tested subjects for grammar, for instance, those who had scored around the bottom guessed that they had scored well above the mean. Conversely, the highly skilled are likely to underestimate their competence.
In the words of Thomas Jefferson: "He who knows best knows how little he knows."
Is your psychiatrist aware of that?