Exerpts from a conversation with Dan Ariely on NPR.
Prof. ARIELY: So imagine, you came to a dentist, you got your x-ray and then we took your x-ray and we also gave it to another dentist.
SIEGEL: Right.
Prof. ARIELY: And we asked both dentists to find cavities. And the question is, what would be the match? How many cavities will they find, both people would find in the same teeth?
SIEGEL: And I'd really hope it would be somewhere up around 95-plus percent.
Prof. ARIELY: That's right. It turns out what Delta Dental tells us is that the probability of this happening is about 50 percent.
SIEGEL: Fifty percent?
Daniel Ariely is a behavioral economist at Duke. He talks occasionallyabout our, well, irrationalities at NPR. He can tell you about your irrational relationship with your dentist, and he can prove to you that Americans know very little about the distribution of wealth in America even though we all wish it were more evenly distributed.
Maybe you'll think twice before signing in to the next appointment with your dentist...
Prof. ARIELY: Fifty percent, right. It's really, really low. It's amazingly low. Now, these are not cavities that the dentist finds by poking in and kind of actually measuring one. It's from x-ray. Now, why is it so low? It's not that one dentist find cavities and one doesn't, they both find cavities, just find them in different teeth.
(Soundbite of laughter)
Prof. ARIELY: And here is what happens. Imagine you're a dentist and you see a patient, and you really want to find a cavity because you get paid more if you find cavities and you can fix them. And the patient is already on the chair. He's already prepped. You might give them the treatment right now, really good marginal income for you. How is this motivation to find cavities will influence your ability?
Now, you look at an x-ray, which is a little fuzzy and unclear and there are shadows and all kinds of things are happening. What happens is this unclarity, thus the x-ray helps in some sense the dentist to interpret noise as signals and find cavities where there aren't really.
SIEGEL: And fill them?
Prof. ARIELY: And fill them, and drill them, expand them. I don't think they ever tell their patients, hey, I thought it was a cavity but turns out it was just a mistake.
Universal, single-payer dental plan, please.
SIEGEL: You're telling us we should, on average, expect our dentist to be getting it wrong on the x-rays, but that's not how people feel about their dentists, right?
Prof. ARIELY: That's right. And the dentists actually have a tremendous loyalty. People are really loyal to their dentist, much more than other medical profession. And I think one of the reasons we go back to cognitive dissonance. Cognitive dissonance is the idea that when people do something painful, they become more committed to the goal. If we have a fraternity and we haze people in a more difficult way, they become more loyal to the fraternity.
SIEGEL: You have dentistry as a hazing experience right now.
Prof. ARIELY: That's right. And I think the same thing happen with dentists. Dentistry is basically the unpleasant experience. They poke in your mouth. It's uncomfortable. It's painful. It's unpleasant. You have to keep your mouth open. And I think all of this pain actually causes cognitive dissonance and cause higher loyalty to your dentist. Because who wants to go through this pain and say, I'm not sure if I did it for the right reason. I'm not sure this is the right guy.
SIEGEL: Every visit to the dentist is an episode in the Stockholm Syndrome here, is what you're describing. You studied these dental insurance records and you looked at what happens over time as our relationship with the dentist grows over many years, and you find it affects the kinds of decisions the dentist and the patient make, the choices.
Prof. ARIELY: That's right. So you can imagine that at some point in your dental treatment, you have a choice between things that have the same possible outcome, but one of them is more expensive to you and better financially for the dentist. Which one would you choose and how the duration of relationship be affecting that?
And it turns out that the more time people have seen the same dentist, the more likely the decision is going to go in favor of the dentist. People are going to go for the treatment that is more expensive but has the same outcome. More out of pocket for them, more money for the doctor. So in this case, loyalty actually creates more benefit for the dentists.
