Sunday, June 19, 2022

Practicing Medicine in the Gray Zone

Many issues have clear and obvious solutions.  Consider some illustrative examples.  If a light bulb has burned out, then most of us would agree that popping in a new bulb should be the enlightened response.  If a flower bed is dry, then we reach for a hose.  If our car’s fuel gauge is nearing empty…   I think you get the point here.

Here's a slightly more complex scenario.  Let’s say that your car has a rattle.  The mechanic may not know the cause or the solution, at least initially, but we can all agree that there is a specific malfunction that can be remediated with a targeted intervention.  As with the dead light bulb example above, there is a specific, reparable defect present. 

Unlike in the automotive world, other disciplines operate with a loose, flexible and proprietary framework.  Consider the financial industry.  One need only read a newspaper’s business section for a week to appreciate the divergence of opinions on financial and investment matters.  Experts cannot agree on the diagnoses or the treatments of sundry economic ailments.  Over the past year or so, for instance, we have seen widely differing explanations of rising inflation and how to combat it.  Of course, political considerations regrettably affect people’s views here, so we may not know what they are really thinking.

If you solicit investment advice from 10 financial experts on where to place funds, you would likely receive a smorgasbord of advice.  Individual stocks?  An annuity?  A managed mutual fund?  Real estate? Tax free municipal bonds?  Or maybe keep as cash for now?   You would be offered an array of financial products with each firm arguing that it would best meet your portfolio’s objectives, after considering market trends, your risk tolerance, age and other factors.   And here’s the confounding part; there is no single correct answer here as there is with a rattle in your car.  Some or even all of the investment firms may be ‘right’.

Everything is not black or white. 

This is the same murky terrain that medical professionals occupy.  Patients’ symptoms are very different from an engine squeak that will disappear after oil is squirted in the right spot.  Consider routine medical symptoms including fatigue, depression, ‘brain fog’, stomach aches, headaches, sleep disturbances, dizziness, nausea or joint pains.  Skilled medical practitioners may disagree on the cause of these stubborn complaints and the preferred path forward.  And similar to the investment industry, various differing medical approaches may be ‘correct’, which can be a vexing reality for patients and their families who have a false sense that there should be a single correct medical response.  Patients who have consulted various physicians for fatigue can corroborate that they have received divergent and conflicting advice.  

If you see 10 gastroenterologists like me with stomach pain, should you expect an unanimous response?  (Hint: answer ‘no’ here.)

When you enter a gray world, don’t expect a black and white solution. 


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