Confidence versus Competence

By John D. Halamka, MD

Sometimes an article inspires and resonates with me. Such was the case two weeks ago when I read about an alternative to the Peter Principle, that suggests you are promoted to your level of misery, not your level of incompetence.

However, incompetence still exists. We’re reminded in the press on a daily basis that we have presidential candidates who are absurdly unqualified.

This week, I read an article in the Harvard Business Review that asks us to separate confidence and competence when evaluating people.

Donald Trump is confident (a legend in his own mind) but is he competent? Carly Fiorina is certainly confident, but did her track record at Lucent and HP illustrate leadership competence?

I’ve hired hundreds of people in my life and my track record has been generally good.

The few mistakes I’ve made, which resulted in voluntary or involuntary separation from the company, have occurred because I was blinded by self-confidence.

In a one hour interview, a person who uses all the correct jargon, is assertive, and is forceful about their opinions can appear competent. Of course, confidence does not imply an ability to lead a consensus discussion, build bridges among stakeholders, or adapt to changing technology.

When I promote from within, it’s easy to evaluate competence because there is a known, objectively observed track record.

When I hire new leaders from outside of healthcare – and it is important to hire innovators with a different perspective – there needs to be an objective screen for competence.

You’d think that references could be such a screen, but all of my “bad hires” have had glowing references. Of course, these references were not from people I know. It makes me wonder if the applicants pre-arranged “reference” calls from their relatives/friends or if the previous employers could not give a compete reference because of legal/separation agreements.

Epic does something novel – it gives prospective employees a written exam that assesses logical thinking and problem solving, not healthcare domain knowledge.

BIDMC has used personality classification instruments to predict cultural fit but has not used any other specific competence tests.

In academic medicine, we sometimes hire leaders for the wrong reason – success with grant applications, a stellar publication record, or amazing teaching skills. These may not imply anything about management competence.

The Harvard Business Review article and personal experience opened my eyes to the need for objective criteria for competence. Epic has the right idea with their competence test. About the only substitute for such a test would be a reference from someone you know and trust. My fellow CIOs are always candid about strengths and weaknesses of our colleagues.

I described the competence/confidence dilemma to a fellow leader earlier this week. They’ve told their children to rely on confidence to get them through a situation for which they lack competence. Good advice for prospective employees, but probably not for prospective employers! Food for thought.

The opinions expressed in this blog post are the author’s only and do not necessarily reflect those of MassDevice.com or its employees.

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