Groupthink and Health: Avoiding the Bandwagon in Medicine and Policy
A friend who had moved to California once told me, “You’ll love it out here. You do what the crowd does, or they’ll leave you behind.”
I was horrified.
Did that mean you stop thinking for yourself and just jump on whatever bandwagon the “crowd” was on? Apparently, it did and that phenomena doesn’t just exist in California—it exists in many professions, political parties, and in the media.
The Dangers of Groupthink
Some examples of groupthink are found in a riveting read from the newly nominated Commissioner of the Food and Drug Administration, Marty Makary, in Blind Spots, When Medicine Gets It Wrong and What It Means for Our Health. From overuse of antibiotics (assuming that there is no harm in prescribing them), to thinking that opioids aren’t addictive, believing that all fats are bad for you, and avoiding peanut products in the young. He documents the harm that is done when every doctor must believe in the groupthink prescriptions. Doctors who challenged the prevailing wisdom were scorned or worse.
Lessons from the Past
Groupthink led us to bad decisions 40 years ago that we are revisiting today. In the 1980s, consumer activists railed against animal fats containing saturated fats (like lard) used for frying in fast-food restaurants. In response, fast-food companies switched to partially hydrogenated oils, i.e., trans fatty acids and consumers switched from butter to supposedly healthier margarines.
By the 1990s, research showed that trans fats were much worse for health than animal fats. In fact, trans fats increased heart disease and increased LDL (bad cholesterol) and decreased HDL (good cholesterol). In addition, trans fats were said to promote inflammation. By 2013, FDA said that trans fatty acids were no longer Generally Recognized As Safe (GRAS).
Animal Fats vs. Vegetable Oils
Today, some (e.g., Robert Kennedy and That Crunchy Mom Kate) are arguing that we need to go back to animal fats and move away from vegetable seed oils (corn oil, safflower oil, and peanut oil), because seed oils contain omega-6 fatty acids that increase chronic inflammation. The claim now is that vegetable seed oils are drivers of obesity and chronic disease. Piling on, a group of nutritionists has stated that “A continued limit on these fats (saturated) is not justified.”
So, do we go back to animal fats?
The Value of Debate
At least this time there is a debate, not a complete groupthink bandwagon like we had in the 80s.
A debate is always better than tacit conspiracies to control the preferred message, as we saw in the COVID prescriptions. From the effectiveness of masks to the belief that vaccines prevent the spread of the virus, much was wrong. Being wrong is OK but saying that everyone who had a different opinion was spreading misinformation was anti-science.
Why Groupthink Persists
It’s easy to see why people gravitate to groupthink. Being part of a self-reenforcing crowd can bring a sense of community. If everyone is playing pickleball for exercise, and you join in, that can be rewarding and worthwhile, even if you could have spent that time doing more rigorous exercise. Joining a club, a church, or a crowd that does things together is good both mentally and physically. Even though it is “conformity bias,” it fulfills a “deep-seated need to belong to a group.” Prior beliefs are strengthened when we are surrounded by people who hold similar views and, even when they are wrong, people cling to beliefs knowing they are right. The latter has been called “the illusion of information adequacy.”
Of course, for most people, these biases are the lowest cost way of determining beliefs. In today’s world with the introduction of over 400 million terabytes (about 83 million pages) per day, joining a trusted crowd makes sense for most people on issues that are peripheral for them.
But just as Dr. Makary has suggested happens in medicine, which he attributes to hubris on the part of doctors, it becomes dangerous when experts, in any field, spread bad information in areas where mistakes carry severe consequences.