I was at a meeting recently (Dental Protection’s ‘Horizons’ seminars) listening to, and enjoying, John Tiernan’s presentation on the ways we think and act. If you missed it, you missed a treat: entertaining, informative and relevant.
Much of the talk was based around the book by Daniel Kahneman: Thinking: Fast and Slow, and while you can’t conjure up John’s talk, you can always go to Waterstones or Amazon and get a copy of that.
Kahneman’s thesis - amply demonstrated by years of evidence - is that when it comes to brain function, we essentially have two systems at work. One primeval system, designed for our days as hunter-gatherers, is quick, efficient and relatively unquestioning. it works like this: (1) Fierce animal? (2) RUN!
The second system has evolved over the past thousands of years to be a logical, slow and reasoning approach. It burns more energy and so we have to switch it on purposively.
Applications in dentistry (as John explained) are myriad. Take this example: (1) New patient? (2) Disease present? (3) Tell patient last dentist was rubbish. OK, one extra step there, but System One thinking. Or try this one: (1) Edentate space (2) Patient looks well-off (3) Implant.
It’s not just dentistry where System One is dominant. Driving yesterday, I was overtaken on the inside on the motorway by a car weaving through traffic. Easy: (1) Dangerous driving (2) Maniac. But then you think about it and go: what if: (1) Phone call to say child has had accident (2) Get home fast (3) Break rules? Still dangerous, but maybe understandable.
In fact System One is omnipresent in society. Think Sun headlines, political soundbites, snappy adverts - all designed to promote instant reactions, which some might call (unwisely) judgements.
Arsene Wenger, 18 years a manager at Arsenal Football Club, put it well when he said: “We have stopped being a thinking society and have become an emotional society”. He was thinking about the immediate knee-jerk reaction to actions both on and off the field of play.
Is this a by-product of the ‘instant’ age, when everything, from emails to apps to TV channel-surfing, has become an immediate reflexive action? When we wrote letters (remember them?) it might be a week before we got a reply. Now people expect their texts or emails answered within minutes or hours at the most. All grist to the mill of System One. I wonder whether one additional factor in the seemingly inexorable rise of complaints, not just against dentists, but many other providers of goods and services, is due to this factor?
And, as Kahneman shows, System One is very persuasive, in fact at times almost impossible to override. He cites an example: “A bat and a ball together cost £1.10. The bat costs £1 more than the ball. How much does the ball cost?” OK, it’s a trick and if you said 10p, you’re wrong, so go figure.
Today, I would never prescribe any treatment for a patient - other than the most basic and urgent - on the basis of a single visit. That’s not a rule by the way, just an experienced guide. Never treat a stranger, as one expert commentator has said. And I would never post (on the net or in the postbox) a message or letter of any significance until I’d saved it, gone and done something else, and then returned to it later and re-read it. It avoids potentially costly and embarrassing mistakes.
At a time when System One seems overwhelmingly to be taking the world by storm, it’s a good idea to think about things a little more slowly, maybe even sleep on it, and just resist the temptation to let the Neanderthal brain take over.