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September 29, 2023

BehindTheMedspeak: Why a lazy doctor is your best bet


John Kay's Financial Times column explored the conundrum of why heroes are those who solve problems rather than avoid them.

Certainly this holds true in medicine, at least in my field: Anesthesiologists with a reputation for being "good in emergencies" seem to be held in higher esteem than those who aren't, even though avoiding emergencies — and thus having little experience with them — seems to me far preferable and indicative of a superior level of expertise.

And if you are lazy like me it very quickly becomes clear — say, within a week or two of beginning your residency — how much easier it is to avoid trouble than to get out of it.

Here's Kay's piece.

No one remembers a cautious captain of industry

I have been reading Joseph Conrad's "Typhoon," the least sentimental of Christmas stories. It describes how Captain MacWhirr and the crew of the Nan-Shan spent the day saving the ship from a storm in the South China Sea. The typhoon broke open the camphor chests belonging to the 200 Chinese labourers on board, leaving a pile of anonymous silver dollars.

The resulting problem has become known as Captain MacWhirr's dilemma. How can you distribute a prize among a group when only the individuals concerned know the size of their contributions and must be expected to exaggerate them? Capt MacWhirr concluded that the only possible solution was to divide the money equally.

Game theorists have constructed a solution to Capt MacWhirr's dilemma that gives an incentive to everyone on board to tell the truth. If you want the answer, I refer you to the Journal of Political Economy for 1981.* But the economists' solution, arithmetically ingenious, is impracticable. Capt MacWhirr "got out of it very well for such a stupid man", as his second officer observed.

The story of Capt MacWhirr is often interpreted as an account of how an unimaginative but determined individual can rise to the occasion. But Capt MacWhirr faced a second and even more common dilemma in which his intellectual limitations served him less well. He saw the signs of the oncoming storm but, having consulted the manuals of seamanship, ignored their recommendations. "Suppose", he says, "I went swinging off my course and came in two days late, and they asked me 'where have you been?' 'Went round to dodge the bad weather,' I would say. 'It must have been dam' bad, they would say. 'Don't know,' I would have to say, 'I've dodged clear of it.' "

If Capt MacWhirr had followed the textbooks, he would have been known only as the skipper who failed to bring his ship into port on time. If Margaret Thatcher had acted to deter Argentina from invading the Falklands, rather than ordering a taskforce to remove the occupying forces after they had landed, she would probably have been remembered as an unsuccessful one-term prime minister.

In politics, business and finance, as on the seas, the hero is the person who tackles a problem, rather than the person whose actions prevent the problem arising. The statesmen we need are those who avert wars and prevent depressions, but such individuals gain little credit. They encounter Capt MacWhirr's second dilemma. These wars and depressions might have been dam' bad. We don't know; we dodged clear of them.

Capt MacWhirr's second dilemma explains the paradox illustrated by Jim Collins in "Good to Great": more successful leaders attracted fewer column inches. Al Dunlap of Scott Paper declared his admiration for Rambo: "Here's a guy who has zero chance of success and always wins." But Mr Dunlap's company was acquired by Kimberly-Clark, whose chief executive for 20 years, Darwin Smith, avoided the storm by taking the company out of the competitive coated paper businesses and into high-value-added consumer products.

Mr Dunlap was a celebrity but Mr Smith is little known. We prefer to read about Lee Iacocca and Lou Gerstner, who held the helm in the storm, or Jack Welch, who managed the ship through turbulence largely of his own creation.

In the financial world, the cautious captain will be fortunate to remain long on the bridge. Since bonuses depend on maintaining a head of steam, diversion from a straight course will prompt a mutiny. It was not difficult to see the credit storm coming. But better for the chief executive to risk his career in the coming tempest than to sacrifice it in a vain attempt to persuade his colleagues to take a circuitous route.

We crave heroes. So we admire ambulance drivers more than traffic police, business visionaries more than competent managers and creative financiers more than advocates of sound money. That is why we often find ourselves at the centre of the storm.

* A Superior Solution to Captain MacWhirr's Problem: An Illustration of Information Problems and Entitlement Structures (Gene E. Mumy, The Journal of Political Economy Vol. 89, No. 5 [Oct., 1981], pp. 1039-1043).

September 29, 2023 at 04:29 PM | Permalink


“A superior pilot uses his superior judgment to avoid situations which require the use of his superior skill” (Frank Borman)

Posted by: Scott | Oct 1, 2023 1:27:52 PM

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