When Experience Overrules Expertise

April 4, 2018

Experts who lack experience with a specific problem aren’t always right.

Regular readers may recall that, just over three years ago, I bought and moved into a new-to-me house. It was an upgrade from my previous digs…but not as much as it appeared. Right off the bat, an assortment of things revealed themselves to be broken and otherwise dysfunctional. I gradually learned that this wasn’t simply a run of bad luck, but rather less-than-wonderful workmanship on the part of whoever had originally built the place.

Case in point: The kitchen ceiling had a leak. Indeed, there was a nor’easter just the week before I closed on the place, providing ample precipitation to prove to everyone that the leak, however slow and intermittent, was still there.

I say “still” because this had plagued the previous owner of the place. Right above the kitchen, there was a second-story deck, and the guy had been advised by whatever experts he trusted that it was the culprit. So, over a course of years, he had the thing overhauled at least twice, and completely redone at least once. The leak came back each time.

I’ll spare you many of the subsequent details, but the upshot is that here we are, just over three years later, and it is only now, as I type this, that I finally have the source for the leak being fixed. You might well wonder why it has taken me this long.

It has not been for want of action on my part. Prior to the team currently clambering about up there, I had at least four well-recommended outfits come by to size up the situation (not counting others who don’t hold themselves forth as roofers but had relevant skills). Every single one of them, sooner or later, said the same thing: It’s the second-story deck. Gotta redo it.

You know from this column that I’m no roofer. Heck, I’m about as non-handy as they come, and I have something of a phobia about climbing on ladders. Still, it never made sense to me that this deck, having been redone from scratch at least once, should continue to be the focus of suspicion. Why take on the obscene expense of once again redoing something when previous efforts had failed to solve the problem?

Still, the roofers were experts on the subject, in which I had zero expertise. One might therefore consider me foolish for doubting them. However, I had gradually gained experience over this course of time. That is, I came to know the patterns of the leak-what type of rainfall (or snowmelt) brought it on, what part of the ceiling dripped first, relevant times of year, etc.

In other words, they might have been experts, but were each encountering the situation de novo, for a short time, whereas I was far more familiar. If the leak had been a person, they might have briefly met him at a party, whereas to me he was an old friend (or, let’s face it, enemy).

Thus (fortunately for my wallet and the ultimate fixing of the issue), I allowed my experience with the situation to override their expertise-and, although it took a bit over three years, managed to track down the source of the problem (nowhere near the deck). This would ultimately be confirmed by my current roofing-team.

More than a couple of times, this has brought to mind the sometimes-blind faith that gets placed in us docs, sometimes by other physicians, as the “experts” we are. I hate being the recipient. Friends and family are awfully quick to forget that I’ve practiced no type of medicine other than radiology for the past decade-plus (giving me experience to go with my expertise), and think nothing of asking me to second-guess the advice of their primary-care docs, obstetricians, etc.

Even nurses and less-experienced docs will not uncommonly ask me things I have no business answering-maybe because they have managed to get me on the phone, whereas a more appropriate specialist would require some additional effort to track down.

Meanwhile, I’m all too ready to give similarly excessive faith to the expertise of the clinicians referring me cases. Yeah, they ordered a whole-body CT with the unhelpful clinical history of “r/o path,” but they didn’t really have that little insight into the patient. Surely, they did a complete H&P, know the detailed signs and symptoms involved, and have a specific plan of action into which the imaging-study reasonably fits.

My high hopes not uncommonly come crashing down to Earth when I find out an exam was actually ordered by ancillary staff because the doc didn’t yet have a chance to see the patient, or a “r/o chole” US was performed on a patient who readily tells the sonographer that he had his gallbladder out ten years ago.

Thus, as with my roofing ordeal, I’ve come to recognize that my experience in doing this stuff has some value, and it’s not always the best move to defer to the expertise of the other healthcare personnel involved. Overriding the latter should definitely involve tact and diplomacy, and can be easier said than done (for instance, when the expert is a surgeon who angrily insists that what I see on the imaging-study cannot possibly be).