Present bias

Estimated reading time at 200 wpm: 4 minutes

If you’re looking for a tutorial depart now and save yourself time and bother. Instead head to Pure bias at Wikepedia and you’ll get your tutorial there. But if you stay on to read this post, you are warned as always that you’ll be putting up with my own thoughts about the concept (and the usual disclaimers apply).

What is present bias.

These are my thoughts. I don’t have to agree with everybody and/or various professors out there. The word ‘present’ instantly stands to connect to some issue about that nebulous place and time people call the future. If you have a bias about the present, then obviously you might get the ‘future’ wrong, in your forecasts or estimates about what may happen. Your plans for the future may not be as robust as you think because unknowingly – as are lots of biases – your thinking might be influenced in the wrong way. But you’re not going to know how wrong, until an unfortunate future unfolds for you. Then you’d beat yourself up – or pardon yourself – by saying “How stupid was I? Why couldn’t I have seen it before?”

You can go on to read about ‘impulsivity‘, ‘procrastination‘ and ‘delayed gratification‘ that are associated by mechanism or side-effects, with the concept.

How it works

Everyday I see people making decisions about what may happen in the future. I often wonder how deeply they are thinking about their evidence. My observation is that most decisions in ordinary professional lives are made swiftly with just a few seconds or minutes of consideration. People do not have sufficient time to think deeply e.g. to consider:

1. a range of competing issues.
2. risk against historical evidence.
3. impact of decisions for the distant future.

 Somebody needs an example. Let’s say you have person X who recently suffered with a mixed-manic and depressive phase of bipolar. X made what appeared to be a near full recovery and was discharged home and doing well at a follow-up clinic visit a few weeks later.  X was on lithium and olanzapine. Then there is a report that 3 weeks after the OPC visit, X is excessively sleepy (around 14 hours per day) and struggling on mornings. What do you do? The traditional approach is to say that the olanzapine at 12.5 mg orally per day is probably causing it (a swift decision or assessment in a team meeting without X present). And the follow on suggestion (aka decision) is either to try reducing the olanzapine or stop it for a while.

The non-traditional approach is to say: “Hold on he’s been on olanzapine 12.5mg for many many weeks without problems. Why is this happening now? Could there be something new happening like a relapse into a depressive phase?” One who is thinking deeply will say ‘Let’s not assume that this is due to olanzapine. Let’s get him in for a FTF review by his psychiatrist ASAP.” Stopping or reducing olanzapine  at that dose is not likely throw somebody into a manic illness if they are covered by lithium as well – and you don’t need to be a psychiatrist or doctor to know that.

But there are even deeper considerations. Like? A decision to reduce any treatment for any outpatient is subject to the law on consent (no references today – it just is). The correct standard is to see the patient understand their problems and then if necessary, with their consent reduce or stop the one that appears likely to be causing a problem. If you go “Yeah.. yeah.. consent means agreement” – then you know nothing about it but you don’t know that. You may wish to or not read the Mental Capacity Act.

If you’re moving swiftly, pathway A is your thing. If you’re me, pathway B is your thing.

What’s this got to do with ‘present bias’? It is about that immediate need to do something quickly – what they refer to as ‘impulsive’ based on information in front of you. The information is there now and people are influenced by it for seeming short term gains.

The roots of present bias

1. When information is readily available, and it looks good.
2. when there is pressure to make quick decisions, often times ‘trying to be helpful’.

Conclusion

I’m not here to tell people how to avoid present bias.  For me, I am just more vigilant of urges to act quickly based on what I see, and what I perceive in the moment. When people are clamouring for ‘action now’ and there is no real emergency I slow things down.