Volume 25, Issue 2
ASA and TSA PAC Contributions:
We know that only 20% of anesthesiologists cooperate in PAC contributions. PAC contributors often feel like the “Sucker” when they contribute because they know there are 4 other non-contributing anesthesiologists that will benefit to the same extent as they did, without participating. If we all contributed, we would be in a much better place politically from mutual cooperation.
Price Collusion: This one is illegal because the United States’ Government doesn’t want physicians to cooperate on price. But, nonetheless it fits nicely in the Prisoner’s Dilemma description.
What are solutions to the Prisoner’s Dilemma?
Recognition of the Dynamic:
Solutions start with understanding the dynamic within a group and recognizing what specific resource each individual competes for most. This can assist in mutual cooperation, transparency and trade offs.
Detection of Cheating or Defection and Transparency:
There are partners that always seem to find excuses for not being available for a case. Often, it is challenging to specifically catch them. But detection of cheating is a strong second step. Under the context of detection, comes the issue of transparency. If all individual actions to garner resources were transparent it would be easier to detect cheating. Hence, there is a great value to transparency when dealing with common resources. However, when an individual defects and starts to compete with other players for those resources, too often they attempt to hide their competitive actions leading to decreased transparency.
Punishment of Cheaters:
Punishment has real value in prevention of a Prisoner’s Dilemma and is a game theory unto itself. Punishment within groups can consist of peer pressure, public condemnation, fining, and removal from the group. The punishment should fit the crime. Over-zealous punishment can lead to “echo” in reprisal. Frequency and degree must surely be thought out carefully.
The Prisoner’s Dilemma Game Theory has great relevance in our everyday life, practices and politics. It is useful to understand its dynamics, to recognize when it is occurring, and to consider measures on how to stop it. We will all have better practice situations if we do.
“Thinking Strategically: The Competitive Edge in Business, Politics, and Everyday Life” by Avinash K. Dixit and Barry J. Nalefuff.