Marc Ackerman, DMD, MBA

We have all had different experiences in life that shape our mental model of the world around us.   Although mental models give us a sense of stability in a world of continuous change, they at the same time obscure facts and ideas that challenge our warmly held beliefs. Mental models, by their very nature, result in some form of cognitive bias. One of the most common types of cognitive bias is anchoring.  Anchoring is a bias that causes one to rely too heavily on the first piece of information that they are told. A great example of cognitive anchoring occurs when a patient has undergone many unsuccessful treatments for a well-documented and confirmed medical diagnosis; yet they are convinced that one of the original, highly unlikely differential diagnoses was wrongly ruled out and that is why treatment has failed.

Some of the brightest minds in business advocate for us to develop a system of overlapping mental models from diverse areas of knowledge in order to prevent faulty decision-making and bad outcomes.  The goal here is to not become trapped in the silo of the small area that we studied in school but to take one’s experience in their field and to scrutinize it using fundamental, basic ideas from other fields that can be applied to any unique situation. What this means in simple terms is that you can utilize general thinking concepts to assess any mental model shaping your beliefs. Karl Popper developed a thought concept called falsification which states that the only way to test the validity of a theory is to prove it wrong. We are really bad at falsification. In fact, it is much more mentally satisfying and easy to find information that proves our perceptions rather than trying to find evidence that we are wrong.  This is called confirmation bias. It explains why we cherry pick information to support our existing ideas.  We can only overcome confirmation bias if we know what it is and if we understand that the concept of falsification is supposed to counteract it.

I have written a series of blogs with my Friend and colleague Ben Burris that have sought to stimulate discussion and to raise awareness of economic and cultural change that is challenging many of the cherished mental models in orthodontics.  We share the opinion that we are entering an exciting period in orthodontics that is going to be shaped by disruptive innovation requiring proactive rather than reactive thinking. In my near 20 years in the orthodontic specialty, I have made many good decisions but would not be telling the truth if I didn’t admit that I made an equal amount of bad decisions. As time has gone by, I have learned to modify and eliminate many of my own flawed mental models because things change.  However, no one is perfect.

When I was a first-year resident in orthodontics, I remember discussing the attributes of a patient’s smile during treatment planning seminar with my Chairman.  He was extremely agitated about the direction of the presentation and when he couldn’t take it anymore he blurted out, “Ackerman, Orthodontics has nothing to do with the smile.”  So of course, being young, naive, way overconfident, and eager to “win”, I continued to argue my point. Wanting to have no more of my incessant volleys, my Chairman yelled, “Don’t confuse me with the facts because my mind is made up!”

My mind will never be made up.  I hope yours won’t be too!