Who Is the Best Surgeon? |
Surgeons who are perceived to be the best are often the most vocal self-promoters.
Shameless self-promoters can overshadow and obfuscate the quality and work of those around them.
Becoming comfortable with realistic self-promotion may help one survive in an environment of narcissists.
You have to undergo a major operation. You’re referred to a surgeon at a large medical center. How do you know if said surgeon is technically superior or even sufficiently proficient in their specialty? Who do you check with? Who would know for sure?
The scary answer is: No one may truly know. Very few people are in a position to judge the technical mastery of a given surgeon. For most specialties, there is no objective way to rate surgeon performance. Instead, we depend on the medical school/residency selection and education process and a couple of specialty board examinations to guarantee a certain level of competence in all surgeons—competence, not necessarily excellence. In fact, I would offer that the process results in a fair amount of variance in the judgment and technical prowess of its practitioners.
Against this backdrop, I have observed that the surgeons who are perceived as the most gifted in a given system are often simply those who tell everyone that they are “the best”—not necessarily the actual top performers. In other words, those perceived as the best are often those who aggressively impression manage (self-promote).
More Than Quality Can Influence Reputation
I have seen similar phenomena in non-surgical medical disciplines, in administrative hierarchies, academia, and the research world, and I suspect that it occurs in many other professions and organizations. Without meaningful objective supporting data and/or informed oversight, the quality of an individual’s work can be far from obvious, opening the door for external assessments to be influenced by more subjective factors—most commonly relentless self-promotion, but also PR efforts, internal politics, networking, nepotism, cronyism, favoritism, bigotry,........