Once upon a time, might made right. One angry mob would holler at another angry mob until one backed down or got pounded.
Tribalism hurt everyone. Thankfully, those days passed, and tribes learned that debate works better.
Once upon a time, doctors learned to debate and wrestle with paradoxical facts. A contest of ideas drove progress.
We learned to disagree violently without violence. Unfortunately, those days have almost passed. Small groups of doctors have resurrected tribes as a way to drive change.
Tribalism
Tribes share an identity that often forms around an idea.
For example, everyone should have the same standard of living, or everyone has the right to a university education, or everyone has the right to play pro basketball.
A tribe applies its collective mind to a vision, an outcome. Tribes work together, study together, play together.
Tribes-as-study-groups often do good things. But tribes are more. They form around identity but transcend the individual.
Tribal identity transcends the individual such that the success of one member is attributed to the whole.
Tribes are enmeshed. Emotion transfers through the group. Tribes amplify emotion.
Instead of a collection of individuals, a tribe becomes a single collective. It feels together. It thinks together. It acts as one.
None of this would worry us, except that, as Kant said, “From the crooked timber of humanity, no straight thing was ever made.”
Tribes form around an identity that is bigger than ideas. Identity creates tribalism. Tribalism creates war and a permanent state of victimhood. Everybody feels that another tribe oppresses him.
Like any group, tribes can fail. They can become angry, turn ugly and form mobs. And as long as they are the only mob around, angry mobs get things done.
You are the acme of virtue. You stand for the betterment of humanity. And so anyone who questions any of that is not just wrong they are against the betterment of humanity.
Consequently they are evil. Not only can you not have an argument with them but you have to put a label around their neck to warn everybody else away and to suppress what they’re saying altogether.
And so you call them names…. And you do frighten people away. It’s very effective as a technique.
- – Melanie Philips
Both those on the Right and the Left use tribalism.
One small group of doctors blocks anyone who disagrees with them on social media. They swarm provincial election candidates and flood them with emails for doing things that they oppose. Could they become the medical alt-right?
Another small group of doctors, a self-identified left-wing organization, does the same thing. When members see a decision that they do not like, they take pictures and post them on social media.
Both groups point and shriek. They think that decibels are an argument. They disdain open debate or discussion. They only know the righteousness of their cause. Anyone who questions their ideology is evil or deranged.
Un-Medical
Mobs and activists undermine the basis of medicine. If we cannot have a rational dialogue about difficult issues, we won’t be able to care for patients.
Female genital mutilation.
Corporal punishment.
Circumcision.
Euthanasia.
Abortion.
Private healthcare.
If every time we run into a difficult issue we form a mob and shriek about our own opinion, we get nowhere.
Regulatory colleges take action when doctors make off-colour jokes or swear. But regulators do nothing when social justice warriors point, shriek and post pictures from a meeting, after the members of the meeting asked them to stop.
Why is one unprofessional but not the other?
If the college has become the arbiter of professionalism, why does it pick and choose?
Tribalism guarantees that we could, once again, become a society of small groups yelling at each other.
Whether it’s the federal tax changes last summer, the physician contract in Quebec, or a recent vote on a topic too sensitive to mention, there’s always a small group ready to protest.
You cannot change society by screaming and yelling or parading in a protest march. The way to convince the majority is through dialogue, debate, discussion and education.
Evelyn Beatrice Hall, Voltaire’s biographer, wrote, “I disapprove of what you say, but I will defend to the death your right to say it.”
Organizers and activists might agree. But they do not see that shrieking, shaming and expressing their outrage is designed to suppress dissent.
Pointing and shrieking at an idea you dislike is the opposite of defending to the death someone else’s right to say what you oppose.
Medicine must stand as a bastion of rational debate in a sea of outrage and activism. We should not create a mob to shut down ideas that we oppose.
Doctors need to discuss and debate ideas that can make us feel uncomfortable, without losing our head and venting on social media.
If we don’t remember how to debate or have a real dialogue, we will dissolve into hollering tribes.
Photo credit: www.thespec.com
Much of modern discussion is hollering. In fact, I think that many, I fear most, have never been in a real formal debate in which you learn to take either side in the debate and argue for or against it.
I think you might be right, Gerry. We have never learned, we never see it modelled and we see everyone else hollering on TV. Not surprising that we see it seep into medicine.
Thanks for taking time to share a comment!
Well thought out and presented. Social media now is the medium for Tribalism that has been present in our parliaments for ions. It is unfortunate that some physicians have succumbed to these tactics. It is easier to form a “Tribe” than express your own views without rancour.
Interesting comment connecting tribalism is parliament, Donald. I hadn’t thought of that angle, but I think you have something there.
You also make a great observation that it takes less effort, and less courage, to form a tribe and shout from the safety of the group. It takes more energy and courage to stand and make a case yourself.
Thanks so much for taking time to share a comment!
Cheers
I would also like people to consider the difference between debate and dialogue. One presumes to hold an idea and defend it. The other presumes a listening and an uncertainty that can lead you places that debate will not. Who was it that said that many of the problems today are caused by people being certain of things about which they ought to be uncertain. Nice work Shawn. Keep up the dialogue.
Great point, Jon!
I added the qualifier about dialogue. Truly, I was not thinking of a formal, scored debate with votes on winners and losers at the end. I don’t know how many of us have been on debating teams. But we all discuss difficult issues.
Thanks so much for helping to improve the post! Great to hear from you.
Cheers
Great blog, Shawn, which should all of us stop and reflect. Not only do we have sub-tribes within our profession, as a profession itself we sometimes behave as a tribe (or a guild) within the health system. Suggest to replace the word “debate”, which implies a winner and a loser, with “dialogue”, which implies shared meaning.
Excellent comment, Johny!
It seems that you and Jon were thinking the same thing. I agree with you. As I said to Jon, “Truly, I was not thinking of a formal, scored debate with votes on winners and losers at the end. I don’t know how many of us have been on debating teams.”
But again, thanks so much for pointing this out! We need the process of dialogue, debate and wrestling with hard issues. I am less concerned with a scored outcome of winners and losers. Indeed, many of these issues are never completely resolved.
Great to hear from you!
Cheers
Tribes or not tribes, people just get outraged when they cannot get the simple/straightforward answer to their quite legitimate questions, e.g. WHERE DOES OUR 54 mln of OMA DUES GO – ?
That’s the biggest elephant in the room & I don’t remember you giving the answer with all the multiple blogs/publications (sorry if I missed it) – ?
Re: “people just get outraged when they cannot get the simple/straightforward answer to their quite legitimate questions, e.g. WHERE DOES OUR 54 mln of OMA DUES GO – ?”
More commonly it is the other way around: those who have an agenda or preconceived notions, just find things to be outraged about because it fits with and advances their own agenda.
Pre-conceived notions (e.g. “OMA Leaders are employees of the state bureaucracy” ) are fed by lack of transparency, not because e.g. the Concerned Doctors are essentially mean/unreasonable:
again, where is the $54 mnl spent every year?
Just some fact & figures, and there will be no reason to form the tribes to get the answers.
Alexey
You raise good questions, but they have nothing to do with the thread. The OMA budget is public. You can come to council to have your questions answered. And you can run for office to help the OMA become the organization you want it to be.
Please get back on topic: dialogue vs. yelling as a way to solve problems.
Thanks so much!
Cheers
Thanks Gerry!
It is the central strategy of the post modernist social justice warrior movement to reduce society into rival warring factions…fixating on “identity” , ” privilege” , ” marginalization”, of the “oppressed” and ” oppressors” , pushing “victimhood” as hard as they can with a particular animus towards western society and the age old relationship between males and females ( Tumbir reports that there are 112 genders) ….there isn’t a crack that they won’t enthusiastically drive a wedge into , to divide it further.
It is the age old totalitarian strategy of dividing society into smaller and smaller hostile fragments so that they could rule and impose their version of ” social justice” on the whole whether they want it or not….it didn’t work in the Soviet Union of yesterday or the North Korea of today.
Thanks Andris.
I like your comments about identity. Identity politics drives division. It creates victims and oppressors. This neo-Marxist view posits that everything is a power struggle. Neo-Marxism resonates with our basic childhood outrage: “That’s not fair!” Nothing about life is fair. No society has ever been fair. The animal kingdom is not fair. I will never play in the NBA and that is life; it has nothing to do with fairness.
Thanks for posting a comment!
Thank you Shawn,
this is an amazing summary/manifesto, and the great comments here & MedPost,
the questions are you defending to death the right of e.g. Concerned Ont Doc’s to deliver their point/concerns – ?
(“I disapprove of what you say, but I will defend to the death your right to say it.”)
If possible, could you put the link to the OMA budget? I cannot find it on the OMA-site.
Excellent post Shawn! Some of these behaviours are just forms of bullying.
Thanks Steve!
I agree. Bullying by another name. Most centrists cower in the face of angry mobs.
Thanks for taking time to share a comment!
Cheers
Agree with Dr Rayevskiy.
OMA budget should be posted online through the OMA website in the interests of transparency.
When there is a lack of information,the ‘void’ will be filled.
Most busy docs would never go to council meetings to get info … I’ve been there,and the ‘process’ is painstakingly slow.
Simple solutions: One registration for Canada allowing for labour mobility. Free market in medicine: as in UK since 1948 with combination of state & private medicine. Replace Provincial College Tribunals ( they are not Courts) by Small claims Courts that do not require a lawyer and pay up to $25,000.