Incompetence Beepers, Lampshade Hats, Kindergarten Probability Classes, Happy False Positives, and Labs Driving Healthcare Off the Fiscal Cliff

In this episode of the PLUGS podcast, Drs. Mike Astion and Geoff Baird
discuss some foundational principles in lab stewardship and management. Give a listen.

05:30 Dunning-Kruger effect: dealing with incompetence through feedback from
annoying logical contrarians.
09:15: The impostor syndrome: Helping lab workers who are experts but afraid to speak
up.
14:30: Lampshades: Would Mike wear one? A discussion of the normalization of
deviance and how it impacts the workplace.
18:15 Slowly drifting into deviance.
20: 00. Is Mike’s use of swear words deviant? Could feedback help?
21:30. Regular football rules vs “Kill the guy with the ball”: How to explain why we need
workplace rules to block the normalization of deviance.
23:50. Geoff thinks Baye’s theorem should be taught in kindergarten, when kids are
learning how to count.
25:00 In screening, finding true positives amongst the false positives is a complex,
anxiety-provoking, and expensive proposition.
28:00 Geoff has a false positive adventure: Even a public health success produces a
large number of anxiety-provoking false positives.
29:30. “I don’t have cancer!” Why aren’t patients angrier about false positives?
31:00 “I don’t have cancer!” Mike’s false cancer diagnosis as an example of cancer
screening challenges
32:00 Lab as a significant driver of unnecessary healthcare costs: excessive inpatient
testing and the need for stewardship.
40:00 Hey, that’s a lot of calcium testing and a whole heap of unnecessary calcium
infusions!
42:00 Alternative revenue sources for clinical labs: Is there revenue beyond clinical
testing?
47:30 Are government dollars clean? And industry dollars dirty?

PLUGS Website:
https://www.schplugs.org/

MTS Website
https://medtraining.org/

Chapters

• 0:00 Intro
• 5:30 Dunning-Kruger effect: dealing with incompetence through feedback from annoying logical contrarians.
• 9:15 The impostor syndrome: Helping lab workers who are experts but afraid to speak up.
• 14:30 Lampshades: Would Mike wear one? A discussion of the normalization of deviance and how it impacts the workplace.
• 18:15 Slowly drifting into deviance
• 20:00 Is Mike’s use of swear words deviant? Could feedback help?
• 21:30 Regular football rules vs “Kill the guy with the ball”: How to explain why we need workplace rules to block the normalization of deviance.
• 23:50 Geoff thinks Baye’s theorem should be taught in kindergarten, when kids are learning how to count.
• 25:00 In screening, finding true positives amongst the false positives is a complex, anxiety-provoking, and expensive proposition.
• 28:00 Geoff has a false positive adventure: Even a public health success produces a large number of anxiety-provoking false positives.
• 29:30 “I don’t have cancer!” Why aren’t patients angrier about false positives?
• 31:00 “I don’t have cancer!” Mike’s false cancer diagnosis as an example of cancer screening challenges
• 32:00 Lab as a significant driver of unnecessary healthcare costs: excessive inpatient testing and the need for stewardship.
• 40:00 Hey, that’s a lot of calcium testing and a whole heap of unnecessary calcium infusions!
• 42:00 Alternative revenue sources for clinical labs: Is there revenue beyond clinical testing?
• 47:30 Are government dollars clean? And industry dollars dirty?