When I use a word . . . . Too much healthcare-self-assessment Underconfidence and overconfidence are the Scylla and Charybdis of medical practice. Too much of the former and you will hesitate and overinvestigate; too much of the latter and you will misdiagnose and overtreat. Either way the patient suffers. The Dunning-Kruger effect supposedly predicts how good people are at self-assessment-those with little knowledge or competence overestimate their ability, while those who are highly competent

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... underestimate it. However, although the reality of the effect has been widely accepted, several criticisms have been raised, including the small numbers studied, the problem of statistical regression to the mean, and the problem of the random noise that accompanies the measurement of self-assessment. In reality, although qualified experts are better at self-assessment than novices are, there is no strong tendency for individuals of all grades of competence to be overconfident in self-assessment and very few people (about 5%) are actually "unskilled and unaware of it," as Kruger and Dunning originally put it.