I was unconscious when he introduced me.

January 2025: “This is Dr. Tricia Groff. She is a business psychologist. Her goals are to hike, run, go shopping, and attend festivals with her friends.”

September 2025: 7-month surgery follow-up

Tricia: “Dr. A, it’s okay if you no longer do this, but your physician’s assistant told me that you tell the team about the patient before the surgery begins?”

Dr. A: “Oh, the introduction. Yes. I tell them as much as I can about you. And you know why? Because I read somewhere that it helps the outcomes when the team is reminded of who you are as a person.”

Dr. A: Also, part of that is for selfish reasons. If something goes wrong in the surgery, I can’t sleep. I lay awake thinking about it.

The day I heard that this surgeon took my goals personally and made the whole team aware of them is the day that I cried because I knew I no longer had to advocate for myself. That caring was the icing on top of the cake. When Dr. A. and I first talked, he’d been able to hold the scientific discourse that had been missing from previous engagements and consults. Bluntly, I trust people who can think, and I abhor overgeneralizations, unfounded assumptions, and cheap reassurance.

May 2024:

I stood in the middle of my kitchen, in my new two-story house, scared in that way that makes one feel small and cold inside. I’d been trying to find answers for the last three years, and multiple professionals had missed the diagnosis of advanced osteoarthritis that required a hip replacement. Because of those misses and all of the contradictory information, I’d developed extreme cynicism about the intellectual rigor of providers. It didn’t help that I’d encountered the same type of simplistic thought in auto diagnostics, real estate, and finance in the same year.

And. Because of my age (40s), I’d likely need a second surgery. So I was trying to make a decision for two surgeries, the one now and the one that would impact my life 30-40 years from now. Yay.

I felt isolated and completely on my own.

In the middle of trying to figure out how I’d assess accuracy in a field completely outside of my wheelhouse, I had an epiphany. The piece that IS in my wheelhouse is my assessment of people, so I decided to use that route for decision-making. I conducted several consultations to find my surgeon, not for a second opinion, but to evaluate their level of abstract reasoning, diagnostic abilities, scientific rigor, and personal ethics. My rationale was that I could compare and contrast them while simultaneously getting a lot of information that would take me hours to figure out on my own, or even with AI.

Over the years, I’ve shied away from discussing how I assess people because some people freak out and think that I’m analyzing them. The thing is, I help my clients assess people all the time, and they’re fine with it. For me personally, the decision to lean hard into that skillset was the best decision I made last year. Hence, the decision to share as much of the rubric as I can articulate.

Here are the main character and intellectual areas I assess, starting with the ones that result in my smiling politely and walking away.

Important: The process of assessing experts crosses industries. Although some variables may differ, the red flags and green lights remain the same.

1. The “Trust Me” Expert

What it looks like: They have an ego that makes them annoyed or dismissive when you ask questions. Any variation of “trust me” should send you running for the exit.

Why this matters: The best experts are simultaneously confident in their abilities and willing to double-check their conclusions. As humans, the moment we assume we’re right, we lose information and fall into confirmation bias—drawing conclusions first, then filling in information to justify them.

Good experts welcome questions because they provide new information and act as safeguards, forcing the expert to verbalize their rationale. They are also happy to have you talk to others because they are focused on you getting the right answers, not validation of their own intelligence. When experts get annoyed with questions, most people pull back to avoid conflict. This is dangerous because it results in missing critical information that could jeopardize the outcome.

Questions also matter because, for many of us, understanding the rationale dramatically improves follow-through. When I grasp the full picture, I make better decisions because I understand the potential upsides or consequences, rather than when I am blindly following someone else’s instructions. Thus, an expert who gets impatient with your questions jeopardizes not only the outcome of the situation at hand, but potentially, the quality of your decisions and future behavior.

2. The Expert Who Doesn’t Know and Doesn’t Try to Find Out

What it looks like: They don’t have an ego, but they can’t answer your questions. They say “I don’t know” and leave it at that.

Why this matters: While “I don’t know” is infinitely better than a simplistic, inaccurate answer, it shouldn’t be the end of the conversation. A complete response includes either a list of potential causes OR explanations for why the answer remains unknown: “We don’t know exactly, but it seems to stem from one of these two things,” or “I don’t know, but let me research it and get back to you.”

Additionally, the best experts inherently need to solve puzzles and problems. It’s internal, not necessarily altruistic, possibly even ego-driven. These driven experts are the ones who will lay in bed at night thinking about a conundrum or spend time going down a rabbit hole to get to the bottom of something. Remember my surgeon’s comment on lying awake at night if something goes wrong? That innate personality quirk means that they are also the type of people who will go the extra mile to get to the right answer.

3. The Expert Who Gives an Answer that Doesn’t Account for All Variables

What it looks like: The expert’s conclusions don’t seem to completely fit your situation, even though you’ve provided them with as much information as possible. The expert may be kind, generally competent, and confident in a way that makes you want to agree…but inside, there is a “but.” Even if you can’t clearly articulate the gap, you sense that there is something else going on.

In the Bernie Madoff documentary, part of the focus was on the SEC and the degree to which several people raised concerns and questions, but were given simplistic or non-answers. The answers came from assumptions and social norms. The SEC failed to “do the math” to account for all variables at hand.

Experts may fail to account for all variables for several reasons. As with the SEC and Madoff,  social conformity and groupthink will make even experts vulnerable to accepting the answers that everyone else has already given. I was privileged to attend a weekly meeting of heart surgeons several years ago. One of my favorite surgeons presented a study in which 9 previous surgeons had advised against a surgery on a simple case. There were no risks and no “math” to support the absence of action. Rather, they’d read the conclusions of the prior consulting surgeons.

Alternatively, some experts lack the critical thought process or internal drive necessary to pursue a comprehensive understanding of the variables at hand.

Why this matters: Accounting for as many variables as possible is critical for root cause analysis and differential diagnosis. That thought process is delineated below, under the section of Green Flags: What Good Experts Do.

4. The Myopic Expert Who Does Not Use Side View and Rearview Mirrors

The way we keep ourselves safe on the roads is to understand that there are variables we may not see when we are only looking through the windshield. The right expert tries to keep their client safe by understanding that there may be variables just outside their present awareness.

What it looks like: The myopic expert conceptualizes the problem according to their area of expertise, and they do not bother assessing alternate explanations that may be adjacent to their purview. They don’t look to the side or in back to see if there are items slightly outside of their field of expertise that may be contributing to the problem.

Why this matters: Experts can only account for the variables in their awareness. Many of those variables come from the client report. Interacting across disciplines, quick Google searches, or AI chats can dramatically increase the awareness of additional variables. Looking only through a single lens at what is directly in front of them increases the chances of misdiagnoses.

1. They Conduct Root Cause Analysis (And Explain It)

First, root cause analysis means getting to the original cause. Sometimes there are layers of causation, so we dig until we find the first mover.

Digestive Example: A person experienced persistent stomach pain, which was caused by excess stomach acid production. The increased acid was triggered by chronic stress from simultaneous major life transitions—a death in the family and significant business changes. This prolonged stress disrupted their gut microbiome, which compromised the gut-brain axis communication that normally helps regulate stress hormones, creating a cycle where their body became less capable of managing the very stress that started the problem.

Relationship example: A couple felt distant from each other, but this feeling of distance was created by fewer deep conversations. This decline in conversations started when one spouse began questioning their relationship due to a decrease in sex, which was triggered by the large new puppy sleeping between them at night. (true story from my counseling days).

Business example: Sales are low due to an inability to compete on price. The inability to compete on price is created by large overhead. The large overhead was created by overspending to project success, which was caused by overcompensation for imposter syndrome, which was caused by the founder’s low confidence in the actual value of the product/service.

Why this matters: Stating the obvious here, but if we don’t understand the cause of a problem, we solve the wrong problem, worsen a problem, or create one that never existed. Without root cause analysis, the digestive issue is treated only with an acid reducer. The couple spends thousands of dollars on couples counseling instead of paying for a dog bed, and the business pays for a sales consultant instead of a person to ameliorate the imposter syndrome. Car repair and problematic team dynamics are other areas in which root cause analysis increases the likelihood that one is actually fixing the right problem.

Green Flag: When an expert does root cause analysis, you should “hear it.” It’s an entire sequence of thought that they’ll explain. Some experts will pick up a paper and start drawing it out to help you see all of the components.  It may not be a long conversation, but there is a clear sense of “why” something occurred. One of my clients recently experienced this. She’d been to several providers and found the right one, who pulled up an image and proceeded to explain in great detail how everything was connected, including an area of concern that another provider had dismissed as irrelevant.

2. They Think in Differential Diagnoses

What this means: Differential diagnoses is a term I learned in my clinical training, but it applies across fields. It is the recognition that multiple causes could create the same pattern of symptoms. Thus, in order to accurately identify the actual cause, there needs to be a systematic approach for ruling out competing explanations.

(It could be X, Y, or Z. But X and Y look very similar on the surface. Let me ask additional questions.)

Examples: Sometimes anxiety and ADHD create the same symptoms. Digestive problems and anxiety can create the same symptoms. Lacking confidence and having a narcissistic personality disorder can create the same symptoms. A problem with the alternator, battery, or ignition may create the same symptoms. Hormonal changes and grief can create the same symptoms. Low organizational trust and a poor sales team can create the same symptoms.

A personal story that illustrates this: As a 22-year-old, stressed graduate student working multiple jobs, my energy suddenly tanked. I’d wake up feeling okay but became exhausted within two hours, often crying because I had no idea of how I’d meet my obligations.

The primary care doctor gave me a depression questionnaire. Since depression impacts energy, I naturally endorsed many items. I watched the click in his eye when he decided that I was depressed. But I had additional information: “I started birth control a month ago for my skin. My periods have been unusually heavy. Could that be related?” (Spoiler alert: drug side effect → heavy iron loss → fatigue → yes.)

He shook his head and wrote a Prozac prescription.

Drug reaction and depression can create the same symptoms.

If the doctor had accounted for all variables and used root cause analysis, he would have been able to conduct a differential diagnosis accurately.

Thankfully, I’d had excellent training from a wickedly sharp mentor, and I knew what to do. I kept the prescription for 30 days (just in case I was wrong), went off birth control, and tore up the prescription a month later when my energy returned.

Green Flag: The expert says, “It could be X or Y,” and they proceed to ask more questions. Again, this applies across industries. If someone says, “I’ve seen exactly this problem; it’s X,” without engaging in additional questions, they are operating out of an availability heuristic (bias created by the examples that come quickly to mind), instead of thoroughly conducting a differential diagnosis.

Personal note: The more I think I’m right, the more I double-check myself and play devil’s advocate against my conclusion. It’s not from low confidence; it’s because I believe that overconfidence creates blind spots.

3. They Have Enough Experience to Sense What Can’t Be Quantified

This is a delicate balance. If experts operate from frameworks they learned 20 years ago without updating themselves, they’ll miss new advances. Hence, experience alone doesn’t make someone a good expert.

However, experience provides what we call “clinical intuition”—the ability to recognize patterns that are difficult to define but crucial for accurate assessment. It’s this sense of “I’ve seen this before.” These patterns and associated variables significantly impact the overall picture, yet they are challenging to locate online, through AI, or in academic texts.

The green flag: An expert with sufficient experience to recognize patterns and stay current with new field developments will reflect this in their communication style. They may say things like, “well, this is what we usually see…” along with a comment such as, “there’s been a new development/I’ve been reading…”. The comments might be spread out in a conversation, but you’ll hear references to both their experience and get a sense that they are still learning and growing.

Alternatively, a new expert who has the intellectual humility to seek input from mentors or colleagues can be incredibly thorough and helpful. They know they don’t know everything, and they go the extra mile to cover the bases. You’ll hear things like, “I’d like to double-check” or “let me research that.”

4. They Share Information and Rationale Proactively (Bonus Points)

I personally love it when experts explain their thinking without me having to ask. It allows me to assess their thought process immediately, making my remaining questions much more targeted. Some experts are truly good, but they may not think about clear communication, or they might assume you already know the information and don’t want to sound patronizing. Alternatively, there are some people who don’t care about the underlying rationale for suggestions.

If experts are holding back because they’re not sure how much information you want, as soon as you ask the first questions, they’ll become a flood of information. It won’t feel like you are pulling teeth, and you’ll end up learning far more than you asked for in the first place.

A fun example on this: I asked my surgeon, who excels in this category, when I could start hiking without worrying that if I fell, I’d screw things up. He proceeded to answer the question, tell me precisely what to do with the hiking poles, and then went online to show me the hiking shoes that might give me the best traction. You can imagine what happened when I asked him deeply scientific questions.

I often quarterback experts on behalf of my clients, but I wasn’t nearly as critical on my own behalf early on in the process. For me, I was vulnerable to underutilizing my own skillset because I wanted to trust that someone else had the answers. I had had a positive experience earlier with the first expert, which led me to be biased toward his conclusions and not request imaging. Additionally, everyone I saw subsequently was highly credentialed or highly referred. I thought I could take a break from the skeptical and somewhat harsh assessment I make on behalf of my clients. I wanted to lean on someone else’s expertise.

My friends and clients are smart but humble. They are also open-minded and want to give people the benefit of the doubt. Sometimes, if people under-estimate their own intelligence, they are more likely to overestimate someone else’s.

Additionally, it can be harder for all of us to make judgments on professionals outside of our field because we lack the foundational information to assess accuracy. It is for this reason that I’ve emphasized paying attention to thought processes rather than simply the amount of knowledge one seems to have.

Finally, when we (at least me) are already stretched thin and lack bandwidth, we may have less intellectual and emotional resources available to invest the time and frustration of getting to the right expert.

What to Do

Don’t go to an expert with the expectation that they will have the right answer. Go with the intention of gathering more information and assessing their thought process. Then, when it’s the right expert, you’ll get the answers as well.

If assessing people isn’t your strong suit, or this type of critical thought makes you want to die, or you are already anxious and barely made it to the end of this article—find a good friend, spouse or colleague to go with you. Ensure that the support person is intellectually skeptical and not shy about asking questions.  Even if you are comfortable assessing the expert, this option can provide a safety net and catch any gaps or questions you may not think of.

Experts who work within incompetent systems may be constrained in how much they can do. This is especially true in healthcare. A competent expert in an incompetent system will face more barriers to achieving the desired outcomes. It doesn’t need to be a deal-breaker, and some experts are fantastic about working around the systems. However, this variable should be considered in the overall picture of choosing an expert. Assess the expert and the system; the importance of each will vary according to your specific needs.

Remember

Whether you’re assessing an expert in healthcare, plumbing, or business, maintain the same rigorous intellectual honesty with yourself. Listen to your instinct and don’t make excuses for them. Have they truly answered your questions? When they do, is there a sense of calm or ‘rightness” you feel because the conclusions fit the problem?  Do you feel that “click” of checking all of the boxes, or are you moving forward partly on faith? Do you feel empowered and comfortable having follow-up conversations?