Collective Decisions

By Gerrit Van Wyk.

About pigs and paradoxes.

Jerry Harvey tells the story of a Texas family who were playing games one day, until someone suggested they take an 80 km trip to Abilene for supper. Everyone agrees to the plan but the trip is long and hot, the food awful, and everyone is unhappy. When they return, they all agree it was a wonderful trip, until grandma says, “it was hot and I thought the food was awful”, which is what everyone is privately thinking. It then comes out nobody wanted to go on the trip. Everyone agreed to go along to keep everyone else happy and would have preferred to stay home. Why is it in groups everyone agrees to courses of action no-one individually want? That’s what Harvey calls the Abilene paradox.

Cuba was invaded from the United States in 1961 with CIA support, which ended in the Bay of Pigs fiasco. With hindsight, those behind the decision fell into the trap of group-think. By searching for conformity, decision making became dysfunctional because it eliminated critical thinking. What mattered more was harmony and minimizing conflict.

We can make logical decisions individually, but collective decisions are social, which trumps logic, creativity, and innovation. Groups both take and avoid risk more than individuals. When a group starts working on a problem, we don’t know what everyone else knows about it and start probing for what they know, but the probing changes our own perspective, which means the group drifts towards an average and we adjust our perspective to conform to it. Consequently, we talk a lot about what we already know, and none about what we don’t, which is what really matters. You now have the conditions for a paradox or a disaster.

We worry if our perspective differs from the group’s and therefore go along with what emerges collectively, and don’t state our own position, pushing the paradox of disagreement into the background. Collective decisions often turn into group-think, which means individuals in a group avoid raising controversial issues or alternative solutions, and give up their creativity and independence to maintain conformity. This lowers the IQ of the whole group and leads to Dunning-Kruger-like conditions where the group imagines it’s more capable than it is. Normal in-group dynamics make the group dysfunctional and resistant to “out-group” contributions, and because we worry about how others will respond to us, we don’t speak out to avoid being perceived as different. The search for harmony makes us yes-men eliminating questioning and creativity, and resulting in easy, wrong decisions.

Teams are often chaotic and don’t think systematically, thereby ignoring the available collective store of knowledge amongst its members, and not discussing what matters. Constant interruptions make them lose focus, and irrelevant issues throw decision making off track. Internal distractions result in random discussions; if you are lonely and low, arrange a meeting. In other words, decision making in teams is social and seldom logical.

Complexity implies diversity, and it is that diversity that allows species to evolve. Intellectual complexity is no different; by eliminating intellectual diversity we eliminate a groups’ ability to adapt and evolve, and set it up for failure. Belbin showed bureaucracies, which are the default in our time, particularly value conformity and therefore eliminate people who are different and ask outside the box questions.

We are often confronted with what Rittel and Webber call wicked problems. Due to their complexity, we cannot understand them by analysis, we can only understand them by interacting with the problem, can’t predict what will or won’t work, and our actions influence the outcome. The problem matters, and there are different perspectives about what is going on, what can be done about it, and when it is solved. Wicked problems are connected to other problems, and how you see reality determines how you go about solving it. It means no experts exist about complex problems, and they can only be solved collectively. It can’t be fixed with storms in our brains, interminable debates, meetings, etc., it requires conversation and dialogue acknowledging the invisible social dynamics behind it to be efficient.

In health care we are confronted with three problems. Because of its complexity, emerging problems are wicked, so we can only solve them collectively. A second, and bigger problem, is managers, leaders, academics, planners, consultants, and bureaucrats are trained to see reality as simple and like a clockwork. It means they are considered “experts” and therefore think they know how to solve complex problems, which they attempt to do by analysis, i.e., exactly the opposite of what is required when confronted with complexity. Until such time as that paradigm changes, we’ll have one foot nailed to the group and will keep shuffling in circles. Making progress means removing that nail and trying something different.

Thirdly, Canadian health care is dominated by large bureaucracies in which conformity and politically correct harmony rules, encouraging the Abilene paradox and group-think,. Different perspectives, creativity, innovation, and whistleblowers are out-group, which means anyone disagreeing with the average and the norm is actively ignored, or, if persistent, shunted sideways, silenced, or eliminated. Thinking and being different in Canadian health care is a dangerous game with steep penalties. And yet, it is that very difference, creativity, innovation, and courage to speak up that creates the conditions for complex systems to adapt and evolve.

Bureaucracies are authoritarian, which is a contradiction in a democratic country like Canada. Management is unelected, appointed, and cannot be democratically removed. Power is centralized, attempts are made to mobilize people around goals and ideologies like lean, and social control is maintained through regulations and the threat of being fired. Professionals are regulated but managers not, which makes them unaccountable, and, no matter what they do, they maintain their legitimacy by appealing to tradition.

Arnstein pointed out true participation in change only exists if employees can make decisions about themselves and are accountable for implementing them. There are approaches for doing this, but that requires health care structures to become more democratic, and those dictating don’t like that. It appears they like being nailed to the ground.

Collective decision making is social, which requires an understanding of the social dynamics behind it, otherwise it becomes dysfunctional; a paradox or fiasco. In our clockwork world, the emphasis is on making decisions, ignoring that complexity, which is why those decisions often go wrong, or, most of the time, are not implemented. The only way out of the lobster pot is to recognize the pickle we are in and changing our thinking about it.