The benefits of admitting mistakes
I recently came across this article in the New York Times that describes a new movement among doctors and hospitals to admit their mistakes rather than continue with the more traditional approach of denying and defending them. As a result, the article suggests, these hospitals are seeing a decline in lawsuits and legal costs. I suspect that this has something to do with the fact that in these hospitals the patients are being treated with an approach that is usually reserved for meaningful, social relationships.
Why? We live in two worlds. The first is governed by social norms, which generally implies that all parties involved share a level of trust and a general understanding that everybody will act with the best intentions, bearing in mind the well being of others in addition to their own. In this social world, small transgressions are usually acknowledged and both parties work together to respectfully fix the situation in a manner that does the least damage to the other. The second world is generally governed by market norms-things like contracts, numbers, and hard facts. In this world both parties tend to be so concerned with sticking to the terms outlined in a contract that the slightest transgression is treated without an ounce of empathy often causing it to evolve into something larger. After all it is a violation of the contract. In this world intentions do not matter and it is only actions that count-you are either fulfilling your contract or you are not.
I suspect that the doctors and the hospitals that have enacted these disclosure policies, have tapped into the power of operating in accordance with social norms so that both the doctor and the patient can work together to prevent a bad situation from becoming worse.
Of course, this disclosure approach is not a panacea, because some patients will still get upset in the social realm and will file a lawsuit (and armed with their doctor’s admittance to a mistake, they might in fact get more money out of the hospital). But, I suspect that this approach will reduce the number of lawsuits to a larger degree than the increase in payment for the remaining ones. I also suspect that it will have a long-term positive effect on the patient-doctor-hospital relationship.
I wonder what is happening to these two worlds over time. Is the % of our interactions that are social norms-driven decreasing over time vis a vis % that are market norms-driven?
Sociologist Zygmunt Bauman would probably argue that the piece of the pie chart that is a fxn of SN v MN is the smallest now that it has ever been, and decreasing. In his Foreword to his 2000 work “Liquid Modernity” he writes:
“the famous phrase ‘melting the solids’, coined a century and a half ago by the authors of The Communist Manifesto, referred to the treatment which the self-confident and exuberant modern spirit awarded the society it found much too stagnant for its taste and much too resistant to shift and mould [Baumant's a Brit] for is ambitions — since it was frozen in its habitual ways…
“The first solids to be melted and the first sacreds to be profaned were traditional loyalties, customary rights and obligations which bound hand and feet, hindered moves and cramped the enterprise… ‘Melting the solids’ meant first and foremost shedding the ‘irrelevant’ obligations standing in the way of rational calculation of effects [read: social norms]; as Max Weber put it, liberating business enterprise from the shackles of the family; or, as Thomas Carlyle would have it, leaving solely the ‘cash nexus’ of the many bonds underlying human mutuality and mutual responsibilities. By the same token, that kind of ‘melting the solids’ left the whole complex network of social relations unstuck — bare, unprotected, unarmed and exposed, impotent to resist the business-inspired rules of action and business-shaped criteria of rationality…
“The melting of solids lead to the progressive untying of economy from its traditional political, ethical and cultural entanglements. It sedimented a new order, defined primarily in economic terms [read: market norms].”
(see also tangential yet related: Glaesser on subversion of justice and rise of regulatory state)
Bauman continues that, in effect, we stripped out these social norms on our own, and it was not some dystopian Zamyatin-esque State that did it to us. We asked for this:
“The present-day situation emerged out of the radical melting of the fetters and manacles rightly or wrongly suspected of limiting the individual freedom and choose and to act. Rigidity of order is the artefact and sediment of the human agents’ freedom.”
Considering this and your write-up:
1. I wonder if there’s a cusp point going on in our society where we are realizing that the market-optimizing calculus to which we have dutifully and increasingly paid obeisance since arguably the late 1800s needs to take into account additional variables –> perhaps, in recognition of the probability of minimizing future lawsuits, attention to social norms is simply the way to still stand at attention to market norms?
2. I wonder if this solid-melting idea of Bauman’s is on to something, given the fact that being honest and human is something that’s newsworthy. If it was the norm to behave as such, there probably wouldn’t be an article about it in the Times … ?
I am so enjoying reading your book and stretching my brain about our irrational predictability and now I have discovered your blog is a wonderful brain-stretch during dull moments at work. Reading your blog today about the clash of social norms and market norms in admitting your mistakes, made me think about pre-nuptial agreements. Maybe the fact that they are such an emotive issue is because they are an introduction of market norms into a very significant social arena. Am I right?
Thanks, Clare.(Happily married and too poor to need a pre-nup!)
Boy! what good fortune to discover your blog just as i’m heading out to a meeting with you as the speaker for BootstrapAustin.org! This Benefits of Admitting Mistakes is perfectly on target for research i’m doing into conversations that require courage (as in such as finally admitting to anything).
thanks so much for making yourself available tonight and sharing your ideas online.