Malcolm Gladwell talks problem solving at Western Health Care Leadership Academy

June 01, 2015
Area(s) of Interest: Physician Leadership Professional Development & Education 

The Western Health Care Leadership Academy kicked off in sunny Hollywood on Friday, bringing Tinseltown a little star power of its own.

The 18th annual event drew in more than 570 participants, with guest speakers including Pulitzer Prize-winning author Siddhartha Mukherjee, M.D.; New York Times bestselling author Malcolm Gladwell; California Lt. Governor Gavin Newsom; Texas Congressman Michael Burgess, M.D.; and California Secretary of State Alex Padilla.

Gladwell, the first keynote speaker at the event, spent his talk illustrating the difference between two conflicting types of problems: mysteries and puzzles — a distinction originally made by national security expert Gregory Treverton.

According to the theory, puzzles occur when there is not enough information to solve a problem. Mysteries, on the other hand, arise when there is more than enough information. Tackling a mystery thus becomes a matter of sifting through the abundance of data, rather than uncovering new information to reach a conclusion.

“This is a crucial distinction because we live in a world [where] most of our institutions and most of our disciplines and most of our expectations and regulations and such are set up on the expectation that what we face are puzzles,” Gladwell said. “And [Treverton] says, ‘look, we don’t face puzzles anymore. The signature problems of the modern world are all mysteries.’”

Gladwell applied the distinction to historical events, stating that the Cold War was a puzzle propelled by a general lack of information, but the 9/11 attacks were a mystery that occurred in the wake of information overload.

However, the distinction can also be applied to medicine, he said.

In past generations, a doctor was a collector of information. Now, a doctor has to be an analyst of information.

Modern physicians must take a different approach to solving the information-laden problems of today, and that requires good judgment and understanding, he explained.

In other words, it requires being a good mystery solver.

“Now here’s the question,” Gladwell said, looking over the crowd of physicians. “Does the world treat you as puzzle solvers, or does it treat you as mystery solvers?”

Gladwell added that the physician’s role today is “infinitely more complicated” and demands more than checking boxes and solving algorithms. So does the doctor-patient relationship, he said.

“We, and by ‘we’ I mean all patients, are terrified,” Gladwell said. “We’re entering a world we don’t understand, that is full of all kinds of questions we didn’t know existed four or five years ago. We want to walk into an office and have someone talk to us and look us in the eye and reassure us and give us guidance and understanding and nurturing and support.”

Gladwell’s presentation drew rapt attention throughout his 40-minute segment and received high praise from those who attended the Western Health Care Leadership Academy, an event spearheaded by the California Medical Association.

In the end, he emphasized the need for physicians to stand up for themselves and say that the nature of their profession has changed.

“You need to stand up to the world and say, ‘we’re not dealing with a puzzle anymore,’” Gladwell said. “We’re dealing with a mystery.”


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