Experts are different -- only four out of twenty seven experienced physicians
correctly identified patients having a heart attack.

The Vice Chairman of Medicine at a major University Medical Center conducted a study to determine the difference between the diagnostic abilities of expert physicians and of experienced physicians.  The study used 85 one-minute silent videos of males who arrived at an emergency room complaining of chest pain.  The physician conducting the study and 26 other experienced physicians viewed the videos.  Each was asked to do only one thing: identify which patients were having heart attacks.

Four physicians correctly identified the 14 patients who were having a heart attack – MI – and gave no false positives.  That is 85 correct answers and no wrong answers.  The likelihood of this happening by chance is virtually zero (p<0.00001).  Those physicians knew what information was relevant and how to use it to make the right diagnosis.

Eleven physicians missed every MI and identified up to 20 false positives.  That is up to 34 wrong answers.  That result is also highly unlikely to have happened by chance.  Either they identified the wrong information or they identified the right information and used it incorrectly when making their decisions.

In the debriefing following the exercise, the physicians who were 100% right could not explain how they accurately identified the patients having a heart attack because they used expert decision-making processes, which are unconscious and happens automatically so they were not aware of their thinking.  Their unconscious thinking enabled them to accurately identify relevant non-digital data by observing the videos and to use that data correctly so that they arrived at the right diagnosis.  In other words, these four physicians recognized the right conditions, which caused them to make and employ the right judgements 100% of the time.  ...More


A two minute video of a physician explains the difference between expert and experienced non-expert performance. While the video is a medical example, what is true of medicine is true for other industries.