“The potential lies in courageous and risk savvy citizens,” writes Gigerenzer.
I think that Gigerenzer is correct to identify the importance of risk savvy citizens. We are more interconnected than we ever have been, and to develop new innovations will require new risks. Many of the institutions we have built today exist to minimize both risk and uncertainty, unintentionally limiting innovation. Moving forward, we will have to develop better relationships toward risk to accept and navigate uncertainty.
A population of risk savvy citizens can help reshape existing institutions, and will have to lean into risk to develop new institutions for the future. This idea was touched on in Bruce Katz and Jeremy Nowak’s book The New Localism where they argue that we need new forms of public private partnerships to manage investment, development, and public asset management. Public agencies, institutions we have relied upon, have trouble managing and accepting risk, even if they are comprised of risk savvy citizens. The solution, Katz and Nowak might suggest, is to reshape institutions so that risk savvy citizens can truly act and respond in ways that successfully manage reasonable risks. Institutions matter, and they need to be reshaped and reformed if our courageous and risk savvy citizens are going to help change the world and solve some of the ills that Gigerenzer highlights.
In his book Risk Savvy Gerd Gigerenzer writes about a private medical panel and lecture series that he participated in. Gigerenzer gave a presentation about the importance of risk literacy between doctors and their patients and how frequently both misinterpret medical statistics. Regarding the dangers this could pose for the medical industry, Gigerenzer wrote the following, recapping a discussion he had with the CEO of the organization hosting the lectures and panel:
“I asked the CEO whether his company would consider it an ethical responsibility to do something about this key problem. The CEO made it clear that his first responsibility is with the shareholders, not patients or doctors. I responded that the banks had also thought so before the subprime crisis. At some point in the future, patients will notice how often they are being misled instead of informed, just as bank customers eventually did. When this happens, the health industry may lose the trust of the public, as happened to the banking industry.”
I focus a lot on healthcare since that is the space where I started my career and where I focused most of my studies during graduate school. I think Gigerenzer is correct in noting that risk literacy builds trust, and that a lack of risk literacy can translate to a lack of trust. Patients trust doctors because health and medicine is complex, and doctors are viewed as learned individuals who can decipher the complexity to help others live well. However, modern medicine is continuing to move into more and more complex fields where statistics and risk play a more prominent role. Understanding genetic test results, knowing whether a given medicine will work for someone based on their microbiome, and using and interpreting AI tools requires proficient risk literacy. If doctors can’t build risk literacy skills, and if they cannot communicate risk to patients, then patients will feel misled, and the trust that doctors have will slowly diminish.
Gigerenzer did not feel that his warning at the panel was well received. “The rest of the panel discussion was about business plans, which really captured the emotions of the health insurers and politicians present. Risk-literate doctors and patients are not part of the business.”
Healthcare has to be patient centered, not shareholder centered. If healthcare is not about patients, then the important but not visible and not always profitable work that is necessary to build risk literacy and build trust won’t take place. Eventually, patients will recognize when they are placed behind shareholders in terms of importance to a hospital, company, or healthcare system, and the results will not be good for their health or for the shareholders.