Groupthink in Medicine

On Groupthink

Consider patient 1 who sees  hair specialist 1. Hair specialist 1 offers a diagnosis of "condition 1". Patient 1 then  sees Hair specialist 2 and Hair specialist 2 reviews the notes of Hair specialist 1 and offers a diagnosis of "condition 1" Patient 1 then sees Hair specialist 3 and Hair specialist 3 reviews the notes from Hair specialist 1 and 2 and offers a diagnosis of "condition 1". Patient 1 then sees Hair specialist 4 and Hair specialist 4 reviews the notes from Hair specialist 1, 2 and 3 and makes a diagnosis of "condition 1."

Patient 1 then sees Hair specialist 5 and Hair specialist 5 does not review the notes of Hair specialist 1 or Hair specialist 2 or Hair specialist 3 or 4. Hair specialist 5 makes a brand new diagnosis of "condition 2"  

So what is the correct diagnosis - "condition 1" or "condition 2"?

Well, there are many possibilities. a) Either hair specialists 1-4 are correct or b) hair specialist 5 is correct or c) nobody is correct or d)  the patient has both conditions or e) the patient has both conditions and perhaps even more. 

One of the beautiful things about being human is how social we are.  Social does not necessarily mean we hop from one party to another but social means we do derive satisfaction from being part of a community and generally trying to get along with others. On account of this there is tremendous pressure, sometimes unknowingly, to agree with others. If you are not aware of the Asch Conformity Experiment, I would encourage you to review it. It’s a fascinating experiment in social psychology.

I encourage all hair specialists to avoid reviewing consult notes from other doctors when seeing a patient UNTIL one has made up their own mind about the diagnosis or treatment plan.  It's tough to do sometimes but it's the best way to force oneself to think critically. 

When you see the consult notes and letters from other specialists, your mind sometimes feels a sense of wanting to go along with the thinking patterns of prior specialists. Not always of course, but I think there is more of a tendency to do so than most people realize. We are wired to be social beings and this makes “Groupthink” common.

Wikipedia defines Groupthink as "a psychological phenomenon that occurs within a group of people in which the desire for harmony or conformity in the group results in an irrational or dysfunctional decision-making outcome. Cohesiveness, or the desire for cohesiveness, in a group may produce a tendency among its members to agree at all costs. This causes the group to minimize conflict and reach a consensus decision without critical evaluation."

Being aware of Groupthink helps individuals and organizations make better decisions.

REFERENCES

[1] Karissa DiPierro  et a. Groupthink among health professional teams in patient care: A scoping review. Med Teach. 2022 Mar;44(3):309-318.

[2] https://en.wikipedia.org/wiki/Groupthink