Groupthink

If the term sounds Orwellian, it's because it is. Fortune magazine then popularized it in the early 50s, and Irving Janice pioneered the formal psychological research on Groupthink Theory soon after. The central tenant is conformity and convergence on a certain idea when a group starts "deliberating". This phenomenon is more pervasive than we realize because not many of us are aware of Groupthink and even if you do become aware of it, it's more or less impossible to shut off without strict systems in place. Scary stuff.  

Cass Sunstein in his book Infotopia writes extensively about the perils of Groupthink. Contrarian opinions are drowned out as everyone is susceptible to confirmation bias. We choose to embolden others with similar views and subconsciously ignore those with different views. This results in meetings, discussions and deliberations where the majority view is the only view.  

Healthcare is an industry that should have already adopted sophisticated methods to elicit information from its experts. Decisions healthcare professionals make  can be among the most important in society. The sad reality though is very little structure and culture exists to overcome obstacles like Groupthink. It's not uncommon to chat about cases over a cafeteria table, during an informal case discussion or  a formal multi-disciplinary meeting. Well intentioned these may be, but the resulting conclusions can be heavily skewed by Groupthink.  

There are known cures to Groupthink. James Surowiecki in his book The Wisdom of Crowds suggests the following as the necessary characteristics for solutions to be viable.  

• Independence
• Diversity
• Decentralization
• Aggregation  

Fulfilling all above characteristics allow an individual to safely elicit their unique knowledge to the betterment of the scenario.  

How to Solve Groupthink?  

Prediction markets, anonymous voting, relying on algorithmic/statistical judgments and having your eyes close whilst deliberating (just joking lol), have been offered as possible solutions to Groupthink.  

In my experience, the Delphi technique and it's variants is the most pragmatic option. Delphi enables, each individual to record (video/write) what they think independently first. The group then views the individual recordings, and modifies their own view accordingly. A consensus can be achieved with the help of a skilled moderator or purpose built software. Efforts to reduce Groupthink will lead to better outcomes for all.