How Pediatric Hospitalists Must Contend With the Expert Halo Effect.

Abstract

In 2015, the American Board of Medical Specialties approved the petition of a group of pediatric hospitalists to make pediatric hospital medicine its own board-certified subspecialty.1 Over the ensuing 4 years, standards for fellowship training and “grandfathering” were developed, and in 2019, the first certifying examination will be offered.2 Although debate exists within the pediatric hospitalist community as to the utility and necessity of obtaining subspecialty status,3 many pediatric hospitalists, especially those at academic centers, will be compelled to become board certified. In so doing, they will assume a title long derided within the community for its association with dogmatic views: subspecialist.4 With this title and the mantle of respect it commands comes the possibility of relying more on expert opinion rather than evidence to settle debates and set policy. Specifically, there is the danger that the expert halo effect5,6 (the assumption of infallibility to an expert) may affect the subspecialty, leading to suboptimal decision-making. Addressing this potential effect and maintaining the core value of the field (practice supported by evidence) is our purpose for …