Business & Practice

Integrative Care

The Dangers of Groupthink

By William Morgan, DC

The term groupthink was coined by the

psychologist Irving Janis in his 1972 work, Victims of Groupthink: A Psychological Study of ForeignPolicy Decisions and Fiascoes. Groupthink describes
what happens when individual thought cedes to
the will of group consciousness. This may sound
like a cross between an Orwellian novel and a bad
zombie movie, but its prevalence in the world is common, and
the dangers of groupthink are all too real, especially when it comes to decision-making in
health care. Groupthink suppresses dissenting
views and can lead to an oversimplified view
of problems and solutions.

In health care, we see groupthink dangers when treatment

risks are considered acceptable by certain specialty groups. Physicians in a group may discuss the nuances of a surgical procedure,
but they do not question the need for surgery. Another medical
specialty may dispense pain medication while rationalizing the
risk-to-benefit ratio. Equally disconcerting are health care administrators and decision-makers who issue decrees for the rest of
society while cloistered away in a boardroom far from the treatment room.

Protect Yourself

Of course, it would be hypocritical for us not

to reflect on our own profession. Certainly, when
chiropractors get together, we can be as guilty as
Symptoms of Groupthink
anyone else when it comes to groupthink. How
Dr. Janis presented eight
can we protect ourselves? Whensymptoms of groupthink:
ever we meet in groups, boards or
Group attitude of invulnercommittees, we need to identify
Group leaders should seek input
ability. The group feels that
the risk of groupthink and take acfrom those with dissenting views. The tive steps to prevent its insidiousit is bulletproof, so it takes
unnecessary risks and is over- organization should encourage open ness from creeping into our midst.
ly confident.
Group leaders should seek input
discussion and feedback. Having
Group rationalismdiscredfrom those with dissenting views.
iting evidence that is con- someone play devils advocate would The organization should encourage
trary to the group beliefs.
also be a way to infuse open thought open discussion and feedback. Hav Group peer pressure inhibits
ing someone play devils advocate
into our organization.
the will to dissent. Memwould also be a way to infuse open
bers of the group are browthought into our organization.
beaten into conformity of thought.
Seeking input from outside the group provides a healthy look
Group belief of moral superiority.
at outside opinions. For example, at the hospital, I frequently
Stereotyping of outsiders in negative termssuch as Oh, call upon other physicians for their opinions in complicated cashe is just a dumb straight. Or, Those medi-practors are so es. Finally, group leaders should avoid stating their opinions so
insecure in their ability to adjust.
strongly that the entire organization is coerced into marching in
Group self-censorship. Peer pressure and stereotyping cre- lock step with them.
ate a spirit of self-censorship. The team members censor
Though Dr. Janis coined groupthink in recent decades, the
their own words and thoughts.
tendency has been recognized for centuries. Hans Christian An Group complacency is fed by the groups culture of self- dersen illustrated it eloquently in his story The Emperors New
censorship and peer pressure.
Clothes, when a little boy broke the trance of national group The appearance of unanimous decisions. Since no one voices think by blurting out that the emperor had no clothes. We need
a dissenting opinion (because of peer pressure, self-censor- to echo the little boys sentiment in defending our profession
ship and stereotyping of dissenters), the group feels that it from the ill effects of groupthink.
always has a unanimous consensus.
Dr. Morgan splits his clinical time between a hospital-based chiropractic
clinic
and two Washington, D.C., executive health clinics. He is adjunct
Several failures have resulted from groupthink: the Maginot
faculty
for F. Edward Hbert School of Medicine, Uniformed Services UniLine, the Y2K millennium bug hoax, global warming (both sides
versity of the Health Sciences and New York College of Chiropractic. He can
of the argument) and the Challenger space shuttle disaster.
be reached through his Web site, www.drmorgan.info.

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| May 2011

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