Ben White

From the free ebook A Manifesto for Applying Behavioral Science from the UK’s Behavioural Insights Team:

The other concern is that [behavorial science] theories can make specific predictions, but they are disconnected from each other – and from a deeper, general framework that can provide broader explanations (like evolutionary theory, for example). The main way this issue affects behavioral science is through heuristics and biases. Examples of individual biases are accessible, popular, and how many people first encounter behavioral science. These ideas are incredibly useful, but have often been presented as lists of standalone curiosities, in a way that is incoherent, reductive, and deadening. They can create overconfident thinking that targeting a specific bias (in isolation) will achieve a certain outcome.

Cognitive biases and mental models make for great blog posts but are really hard to put into practice as an individual or effectively guide policy as an organization.

For further reading, try Nudge (the new/final edition was just released in 2021).

// 08.28.23

AutoHotkey for Radiology

08.25.23 // Radiology

AutoHotkey is powerful free software you can use to control your computer and generate simple (or complex) macros to automate tedious or repetitive tasks.

For radiology, I consider the most important ability AHK enables is true hands-free dictation.

Ultimately, you can go crazy with this power, and it only takes a few minutes to learn how to use the software. The AHK website includes beginner tutorials and examples, and ChatGPT is even familiar enough with AHK scripting to get you most of the way. You don’t really need to understand very much in order to use it.

Randall Munroe, author of the always wonderful XKCD and Thing Explainer, illustrates why basically every radiologist should be doing this:

Please note that I am far from an expert on AHK or scripting in general. I started this journey in order to more effectively ditch the dictaphone, and–once I started–realized I also just dislike wasting my time.

I promise: The small investment in time and energy is absolutely worth it.
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In a similar vein to our recent discussion of radiology practice and game theory, this is from Andrew K. Moriarity’s new article in JACR, “Pirate Practice”:

Employed sailors could count on the guarantee of agreed-upon pay in return for work performed. However, each pirate must be primarily motivated to ensure group success by their own self-interest because each endeavor lasted only as long cooperation maximized profits over expenses.

[…]

In considering the cooperation needed among individuals for a successful voyage to keep moving forward, perhaps Jack Sparrow was right to conclude that “not all treasure is silver and gold, mate.”

// 08.24.23

Humans–with some incredible diligence and lots of practice–can do such fascinating things.

Pretty unreal.

// 08.23.23

Hold in the back of your mind the notion that someday you’re gonna write a book. You don’t have to write it this year. Meanwhile, writing begets writing. Just get into some kind of situation where you are writing, and if it’s some various thing you’re publishing online, it’s still grist to the mill.

Legendary nonfiction writer John McPhee in an interview with GQ at the tender age of 92. For further reading, see Draft No. 4.

// 08.22.23

From Tanner Greer’s The Scholar’s Stage:

The professionalization of intellectual pursuit is another problem. Melville would never have written Moby Dick if he had spent years enrolled in an MFA program instead of spending years at sea. Men and women who in past ages would have observed humanity up close (or at least who would have been forced through a broad but rigorous education in classics) instead cloister themselves in ivory towers. Their intellectual energy is channeled into ever more specialized academic fields and cautiously climbing a bureaucratic and over-managed academic ladder. Could that social scene ever produce a great work?

// 08.21.23

Great reporting by Cezary Podkul in ProPublica (and amazing perseverance by Dr. Shteynshlyuger):

A powerful lobbyist convinced a federal agency that doctors can be forced to pay fees on money that health insurers owe them. Big companies rake in profits while doctors are saddled with yet another cost in a burdensome health care system.

// 08.16.23

I’ll be giving the keynote at the FSU College of Medicine’s Business & Medicine Symposium in Tallahassee this Saturday. If you’re a student there, make sure to come say hi during the morning coffee or lunch after!

// 08.15.23

Radiology, Private Equity, and the Prisoner’s Dilemma

08.14.23 // Radiology

Last week, Dr. Ashutosh Rao from Quantum Radiology wrote an email with an interesting take on the corporate ownership of radiology practices as seen through the lens of Game Theory. He was gracious enough to allow me to share a version of it here for your enjoyment.

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For decades, the unwritten covenant between private practice partners (owners) and new hires (associates) was that a practice that had been built and maintained for years by owners would be handed off to associates to build and maintain for yet another generation of partners. This prior stable equilibrium [Cooperate, Cooperate] has been disrupted (by yield-hungry investors) and we have a new stable equilibrium [Defect, Defect].

The available equilibria:

  • Stable equilibrium #1 [Cooperate, Cooperate]: Practice owners build for the future. Associates build for the future.
  • Unstable equilibrium #1 [Cooperate, Defect]: Practice owners build for the future. Associates won’t build for the future; they are clock-in/clock-out.
  • Unstable equilibrium #2 [Defect, Cooperate]: Practice owners don’t care about the future and sell the practice for $$$. Associates who wanted to build for the future are shut out.
  • Stable equilibrium #2 [Defect, Defect]: Practice owners extract what they can from the practice. Associates extract what they can from the practice.

Accusation: Owners (often pejoratively grouped as “boomers”) have screwed their associates by allowing working conditions to deteriorate and then selling out.

Accusation: Associates (often dismissed as “millennials”) just want to clock in and clock out and don’t care about the practice, so owners should sell before the practice deteriorates.

And so here we are. From “The Prisoner’s Dilemma”:

Defection always results in a better payoff than cooperation, so it is a strictly dominant strategy for both players. Mutual defection is the only strong Nash equilibrium in the game. Since the collectively ideal result of mutual cooperation is irrational from a self-interested standpoint, this Nash equilibrium is not Pareto efficient.

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Thanks again to Dr. Rao.

In game theory, a Nash equilibrium is the outcome in which no player can benefit from unilaterally changing their choice. Pareto efficiency refers to a situation in which it’s not possible to make any individual better off without making someone else worse off.

The Prisoner’s dilemma is an example of a game that is not Pareto efficient: the optimal outcome for the field of radiology would be for both parties to cooperate. If only. Unfortunately, a series of individually rational choices doesn’t always lead to the best collective outcome.