A former deputy commissioner at the New York City Health Department says a 2013 meeting with Elizabeth Holmes and her Theranos team showed how confidence and powerful connections can make even knowledgeable professionals question their judgment.
The official, who oversaw infectious disease programs and the city’s public health laboratory, joined an hour-long video call with Holmes, her colleagues and the laboratory director. Theranos representatives said the company had developed a way to run blood tests using small samples, reducing costs by 30 percent. They also claimed a wide range of tests had been validated, regulatory approvals were complete, the company had a Department of Defense contract, and testing would soon begin at Walgreens pharmacies in New York.
Asked for the scientific evidence and data behind those claims, the team said it could not share business secrets but assured the officials that the technology worked and had been approved. The former official says the claims did not fit with what the two public health colleagues knew about specimen collection, test validation and regulatory approval. Still, Holmes’s certainty and the stature of Theranos’s investors and connections led them to wonder whether she knew something they did not.
The officials offered to evaluate the device in their laboratory before it was used more widely, but neither side followed up. After The Wall Street Journal published its first investigation of Theranos in October 2015, the two colleagues agreed that their doubts had been justified. The author writes that most of what Holmes had said in the meeting was untrue.
Reflecting on the encounter, the former official warns that confidence should not be confused with competence. People may be especially likely to trust confident claims when checking them is difficult or costly. The author also describes the “halo effect”: credibility in one area can lead people to assume expertise in another. Prestigious backgrounds among Theranos’s funders and board members, the author says, contributed to the assumption that they had properly evaluated the technology, even though they lacked laboratory medicine expertise.
Healthcare requires people to rely on others’ knowledge. Physicians depend on radiologists to interpret scans and laboratory staff to perform tests correctly; patients, most of whom are not medical experts, must make similar decisions with even less specialist knowledge. The author notes that medical errors occur and that accepted knowledge can change over time, encouraging patients to ask questions and seek second opinions for major decisions.
To judge health claims, the author suggests considering whether the person has relevant experience, rather than relying on fame or business credentials. It is also worth asking what evidence supports a recommendation, whether it aligns with expert guidelines, and whether independent bodies or professional organizations have reviewed it. Experts who can support their claims should be able to explain their reasoning or point to studies and published guidance.
The author concludes that health institutions need access to methods and data to assess whether treatments and other interventions are safe and effective. When someone asks for trust but does not provide evidence, people should consider relying on their own informed judgment or seeking another opinion.
Sources: Psychology Today.