The Psychology of the Doctors Strike in the UK by Raj Persaud and Peter Bruggen

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As doctors go on strike in the UK, the nation appears to be on the threshold of an unprecedented wave of industrial action by physicians. These strikes could culminate in a walk out in the near future, which might even close emergency rooms in hospitals.

 

 

 

One psychological theory about conflicts is if there is a winner and loser at the end of a bruising and damaging dispute, then the loser usually suffers more after the fight, than if they had anticipated their eventual defeat, and withdrawn before engaging in combat.

 

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In conflicts one side is making an error in having the battle, and their error is an over-estimation of their chances of victory.

 

 

 

The peculiar psychological tendency of human beings to over-optimistically assume their side is going to win is thought to account for why as a species we fight with each other a lot more than the rest of the animal kingdom do.

 

 

 

Most other animals engage in a face-off of threat display where both sides are making an evaluation of who is likely to triumph in a skirmish, and usually the potential loser spots that reality early, and backs down, as a result saving themselves from worse injury had they continued with the bout.

 

 

 

So in this case, the war between the doctors and Jeremy Hunt, the UK Minister for Health, which side is too ‘ego-involved’ to possess the humility to know they can’t win?

 

 

 

A recent study entitled ‘A study of expressive choice and strikes’,  explains that one way of thinking about why conflicts within organisations such as strikes happen at all, is that they simply arise out of an information imbalance between the two warring parties.

 

 

 

In this model strikes are caused by an asymmetry of information about the profitability of the organisation, or the potential rewards available to be passed on to workers.

 

 

 

Union members don’t know the true state of the accounts in a firm, and are uninformed ultimately about what is possible, but are guessing that management are withholding rewards or keeping them for themselves, and a strike occurs as a way of clarifying the true case.

 

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In contrast, management are always perfectly informed about what largesse they could bestow on the workplace, hence the notion of a fundamental asymmetry of information in play in these conflicts.

 

 

 

In some cases, the authors, economists from the Norwegian University of Science and Technology, University of Oxford, King’s College London, and the University of Queensland, contend that strikes occur because unions overestimate the profitability of their employers, and demand too high a wage. This leads to a strike, which lasts until the union settles for a lower wage, because the management just couldn’t offer any more, no matter how punitive the strike was.

 

 

 

If there is perfect fact sharing and trust about that information as regards what rewards are available for the workers from the management, then there is no need for a strike, as both sides should be able to agree on a fair outcome.

 

 

 

Strikes can also serve a psychological function, because if the union were never to strike, the employer would always offer the lowest possible remuneration, particularly when they know what is possible and the other side don’t. One key ‘mental’ aspect of strikes then is to make management fearful of their possibility, and this makes sure they don’t exploit the information advantage they have.

 

 

 

This new study, published in the ‘European Journal of Political Economy’, contends that the asymmetry of information that is the driving force behind strikes also runs the other way – in particular employers often don’t know how upset or ‘emotional’ the workers have become and as a result they under-estimate this factor.

 

 

 

Theoretically workers should take into account the damage to themselves and potential personal cost of striking, and this should often put them off taking industrial action, at least in scenarios where the key actors are assumed to be perfectly lucid.

 

 

 

Strikes therefore can happen because the management erroneously assume the workers wouldn’t go on strike on purely rational grounds, given all the data available on what rewards are possible.

 

 

This new study by Christa Brunnschweiler, Colin Jennings and Ian MacKenzie, has produced a new finding suggesting that sometimes in strikes the employer is not fully informed about the level of emotionality or ’expressiveness’ among union members. This finding seems to fit the current predicament doctors working in the NHS find themselves in.

 

 

‘Expressiveness’ here refers to an emotional need to act or do something, such as go on strike, as opposed to not taking industrial action, because of a more rational or calculated assessment of what outcome is likely.

 

 

 

This study raises the question of whether one flaw at the heart of the Government’s strategy is to ignore the deeply emotional element to doctors’ growing resentment at their treatment by the NHS.

 

 

 

If union members are upset, they may vote for a strike on passionate grounds, even though they would not have done so if they were choosing purely on what their rational estimation of how likely they are to benefit from the strike.

 

 

 

This study argues that if employers had fuller knowledge about the exact level of emotionality within a union, they would set the wage or rewards at the lowest level that would avoid a strike. However, management often don’t have this knowledge, and as a result frequently underestimate emotionality and offer rewards which are too low, such that union members vote for strike action.

 

 

 

The study contends that a perception of unfairness provides an expressive benefit to vote for a strike. It makes the workers feel better. The asymmetry of information that underlies all strikes is now reversed such that management are uninformed about the emotionality of union members.

 

 

The authors of the study claim that an empirical test using UK data from the Workplace Employment Relations Survey provides support for their predictions.

 

 

Yet the NHS is very different from a commercial firm, so maybe other factors are in play.

 

 

The key audience here are the stake-holders or the public. Victory in this dispute hinges on who is able to consistently command public support. But it’s doctors, not politicians, who encounter and care for the public, in the form of patients, every day.

 

 

 

This new research suggests its possible one side is suffering from an information asymmetry as regards the voters.

 

 

 

The latest polling finds a dramatic drop in public support for the doctors’ strike, if emergency services are affected. So it’s still possible the British Medical Association might yet snatch defeat from the jaws of victory, if they don’t fully appreciate that other key stake-holders – such as journalists – are not usually great supporters of doctors.

 

 

 

But with polls suggesting two-thirds of the public currently back the junior doctor strike, the Government’s gambling the NHS’s future on Jeremy Hunt’s bedside manner, so far, doesn’t look like its paying off.

 

 

Christa Brunnschweiler, one of the authors of the original paper and now at the University of East Anglia, points out that the research team had originally posited (but left this point out of the final paper), that the sense of unfairness and the willingness to act expressively could be heightened when union dissatisfaction is channeled against individual employers that are perceived as particularly unfair. The authors had pointed to the examples in the past of British Airway’s Willie Walsh and the Chicago Teachers Union pitted against the city mayor, Rahm Emanuel.

 

 

Both these figures contributed to heightened emotionality, judging by news coverage at the time. Maybe the UK’s Minister for Health, Jeremy Hunt is having a similar effect?

 

 

 

Follow Dr Raj Persaud on Twitter: http://www.twitter.com/(link is external)(link is external)(link is external)@DrRajPersaud

 

Raj Persaud and Peter Bruggen are joint podcast editors for the Royal College of Psychiatrists and also now have a free app on iTunes and Google Play store entitled ‘Raj Persaud in conversation’, which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

 

Download it free from these links:

 

https://play.google.com/store/apps/details?id=com.rajpersaud.android.raj

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id9274662

 

Dr Raj Persaud’s new novel – a psychological thriller which poses the question – ‘is lovethe most dangerous emotion?’ – is based on a unique police unit that really does protect Buckingham Palace from fixated obsessives – ‘Can’t Get You Out Of My Head’ – and is now available to order on line.

 

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