Stop the tribal warfare

Before there was a self, there was the tribe.

"Our earliest ancestors did not stand alone; they banded together to survive. For vast stretches of history, our consciousness was shaped by our connections to the people in closest proximity to us. Identity was like a complicated address, at the intersection of birthplace and blood, the things we chose to worship and the ways we kept ourselves alive, in a finite landscape we knew as both home and world. We were defined not by our hidden interior life but by our outward gestures, the rituals and markings we shared, the tributes we paid to common ideals of goodness and beauty — not by what made us different but by what made us the same."

Medical tribal warfare is increasing, and it is making the US siloed, sick, sick care system of systems worse, inflicting collateral damage on patients.

Examples are:

1. Red v blue medicine
2. The lost Tribes of Medicine
3. Medical turf wars
4. Why doctors don't play nice with each other
5. How to destroy your sick care innovation silos
6. Open InNOvation
7. We need interprofessional bioentrepreneurship and innovation education, training, and development
8. The missing piece of medical professionalism
9. How to close the doctor-data scientist-bioengineer divide
10. Unprofessional courtesy
11. Are culture wars winnable and at what cost?
12. Value gaps

Examples of gaps are:

Clinician-administrator

Industry-academic medical center

Clinician-patient

Clinician-payor

Policy maker-clinician

Clinician-data scientist-engineer

Entrepreneur-investor

Medical student/resident-educator

Physicians-county, state, and national medical societies

Premedical students-medical schools

Opinion columnist, David French, reminds us that "it’s a fact of human nature that when like-minded people gather, they tend to become more extreme. This concept — called the law of group polarization — applies across ideological and institutional lines. The term was most clearly defined and popularized in a 1999 paper by Cass Sunstein. The law of group polarization, according to Sunstein, “helps to explain extremism, ‘radicalization,’ cultural shifts and the behavior of political parties and religious organizations.”

What is group polarization?

• Group polarization is the tendency for groups to show a shift towards the extremes of decision-making when compared to decisions made by individuals.
• When individual members of a group are already cautious in their attitude to a decision, they will show a shift toward an even more cautious attitude when they discuss this as part of a like-minded group.
• When individuals are less cautious before a group discussion, they tend to show a shift towards more risky decisions when they are making a decision as part of a like-minded group. This type of group polarization is known as a risky shift.
• On average, groups will polarize (show accentuated judgments) toward the attitudes held before the group decision is reached.

Doctors should collaborate with each other and other healthcare professionals and those outside of medicine because:

There is strength in numbers

It helps to rediscover the Lost Tribe of Medicine and build community

It is in your self-interest to build your internal and external networks

The enemy of my enemy is my friend

It serves the interests of patients

It helps to achieve the goals of mission driven organizations, like regional, state, national, international, and specialty medical societies.

Where you sit today might not be where you sit tomorrow, and you might need help finding an empty chair

It sets an example for younger generations of doctors

It is empowering and helps to restore the joy of medicine

Misery loves company

Of course, when it comes to which team you want to win the next subway series, that's a different conversation.

The law of group polarization, unlike the laws of nature, can be changed unless you think human nature is immutable.

Or maybe AI can help bridge the gaps.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack