The language of caring

Emotional intelligence and physician success

by

Emotional intelligence is one of many buzzwords that has swept professional development in recent years. Often seen by its shorthand EI or EQ, emotional intelligence is the ability to recognize, regulate and empathize with emotions—both your own and others’. According to EQ advocates, flexing EQ muscles can offer a multitude of benefits to practicing physicians, from patient empathy to being a more collaborative team member and leader, to looking after your own emotional needs and preventing burnout.1

“The language of caring is universal,” says Janice Newsome, MD, FSIR, “and we can all choose to speak it.” According to Dr. Newsome, an IR at Emory University Hospital in Atlanta, in an era when individuals are combatting global health crises, cultural unrest and pushing for a more informed society, the need for emotional intelligence in health care providers has never been more crucial.

What is EQ?

Journalist Daniel Goleman popularized the idea of EQ in 1995 with his book Emotional Intelligence,2 which used the work of psychologists John D. Mayer, PhD, of the University of New Hampshire, and Peter Salovey, PhD, of Yale University, to posit the idea that awareness and control of emotions could improve interactions with others.3 Drs. Mayer and Salovey state that, “[Emotional intelligence is a] form of social intelligence that involves the ability to monitor one’s own and others’ feelings and emotions, to discriminate among them, and to use this information to guide one’s thinking and action.”

Drs. Meyer and Salovey highlighted four specific abilities that encompass EQ3:

  • Recognizing and identifying emotions in yourself and others
  • Understanding emotions and their origin
  • Utilizing emotional understanding to impact thinking and problem solving
  • Regulating your own emotional reactions

Research has not established whether EQ is a trait or a learned ability, research shows that physicians who receive even brief training on the neurobiology of empathy received significantly higher empathy scores from patients.4

Becoming aware

Self-awareness may be the key aspect of EQ.2 In a situation where your emotions have flared—or have hijacked the situation, as Mr. Goleman describes it—self-awareness is crucial. Goleman recommends stepping back and asking why you felt that way, determining whether your emotional reaction was appropriate, whether it helped or harmed you, and how you would respond to a similar situation in the future.1,2

This is where empathy comes into play. Once you’ve assessed your own actions, empathy allows you to understand the other party’s emotions and situation to better understand why they reacted as they did. This may spur you to take responsibility for your own role in the situation.1

After completing these assessments, the individual can use the understanding they’ve gained to inform how they problem-solve and collaborate in the future, as well as better recognize and react to their own emotions going forward.

“It’s very much about intention,” Dr. Newsome says. “If we take intentional steps—examining our unconscious bias, considering how others view us and assessing how we view others—then caring becomes part of our daily routine. It becomes easy, and we become better at it.”

Relating to patients

Patient empathy or “bedside manner” is one of the key skills any patient-facing physician must master—and it’s one that can be difficult to find time for in hectic schedules, unexpected problems and pressures of the system. In addition, communication barriers sometimes exist, either with language or conveying complex medical issues in a way a patient can comprehend. Being empathetic of cultural and socioeconomic differences can spur physicians to think more critically about how they approach patient care and interaction. “If you take the time to understand a patient, how they live and how other factors of their life can intersect with the disease process, you will have a better understanding of your patient than you could read in a file,” Dr. Newsome says.

Applying EQ can also help IRs problem-solve more effectively—perhaps by acknowledging their own barriers and seeking guidance from someone who may be able to better speak, communicate or empathize with a patient. For example, in FAQS in Interventional Radiology, Volume 6, John “J.T.” Thomas, MD, suggests seeking outside expertise in his pearl on uterine fibroid embolization (UFE).5 “If you work with a nurse or tech who has had UFE, let them speak to your patients about their experience.”

Effective leadership

One of the most crucial areas where EQ can play a role is in leadership. Many traits of successful leaders—mindfulness, patience, empathy, ability to collaborate—are also tied to EQ.6

“You have to learn to understand beyond words,” Dr. Newsome says. Emotional understanding is crucial for leading—a role that requires navigating disagreements or difficult discussions, providing professional support and utilizing both the strengths and weaknesses of team members.1,6

But according to Dr. Newsome, being a leader isn’t just managing your team’s emotions—it’s managing your own as well. “As a physician leader, your emotions guide your team. Your temperament on any given day will influence not just your partners, but the patients they see. You set the climate,” Dr. Newsome says. And it can sometimes be a burden to provide the calm, collaborative atmosphere that is crucial to encouraging employees and supporting their needs.

“I try to acknowledge the small stresses, because if I don’t and then bring them into work, it will build up,” Dr. Newsome says. “So I acknowledge them, set them aside and then tap into my own resilience.”

“Every balloon has a burst rate. We can track the PSI and be prepared and work to make sure we don’t push the balloon past capacity—but it’s harder to check in and discover your own burst rate. Typically, we don’t realize what it is until it’s too late.”

 Janice Newsome, MD, FSIR

Preventing burnout

For a long time, Dr. Newsome says, she didn’t know the term “burnout” was used outside of medicine, because it’s something so prevalent in the medical community.

According to the Medscape National Physician Burnout & Suicide Report 2020, 42% of physicians reported feeling burned out.7 Medscape defines burnout as “long-term, unresolvable job-related stress that leads to exhaustion, cynicism, feelings of detachment from one’s job responsibilities and lack of a sense of personal accomplishment.”

Empathy and self-awareness are key to preventing these feelings, Dr. Newsome says. She likens IRs and their emotional capacity to the balloons that they work with. “Every balloon has a burst rate. We can track the PSI and be prepared and work to make sure we don’t push the balloon past capacity—but it’s harder to check in and discover your own burst rate. Typically, we don’t realize what it is until it’s too late.”

Being aware of your own emotions makes it easier to check in on yourself, to see how you are doing and take steps to protect your own well-being.8

A marketable skill

Much has been said of the effectiveness of learning and implementing EQ in order to become a more collaborative and aware team member.9 The World Economic Forum ranked EQ as one of the top ten skills needed in the workplace in 2020.10 Training programs have been designed to teach individuals how to assess their EQ. Workplaces can hire consultants to assess their employees’ basic emotional regulation skills and provide courses to encourage improvement using hands-on, practical application examples.11

“It’s hard to reach folks who dismiss this as some kind of fad,” Dr. Newsome says. “And there are so many great IRs who care for their patients—but may not extend that care to themselves.” But for newly emerging IRs, Dr. Newsome says, it’s crucial they understand that this language of caring is becoming a prerequisite for their future jobs.

When asked to give references, Dr. Newsome says she is often asked not only about the candidate’s technical skills, but their emotional ones. “What kind of mood are they in? Do they collaborate well with others? Do they handle stress? How do they make their coworkers and patients feel? Are they capable of asking for help?” These are all skills that can be improved through regular self-assessment and practicing empathy.

To some, adjusting life and business around a more empathetic and emotionally aware approach may seem difficult. But Dr. Newsome believes it’s not. “The pandemic has shown that the entire medical field can change our systems in a week if we want to,” Dr. Newsome says. “Nothing is impossible anymore.”

Additional reading

In 2011, IR James G. Caridi, MD, FSIR, was diagnosed with myeloma. “I thought I was a good blue-collar doctor,” he said, “until I went on the other side of the glass and saw how much I was leaving behind.” Read more about the advice he now gives colleagues for building patient empathy at bit.ly/2mwNNV5.

References:

  1. James TA. Emotional Intelligence for Physician Leaders. Lean Forward, Harvard Medical School. https://leanforward.hms.harvard.edu/2019/06/13/emotional-intelligence-for-physician-leaders/. Published August 10, 2020.
  2. Goleman D. Emotional Intelligence. New York: Bantam Books; 1995.
  3. Salovey, P., & Mayer, J. D. (1990). Emotional Intelligence. Imagination, Cognition and Personality, 9(3), 185–211. https://doi.org/10.2190/DUGG-P24E-52WK-6CDG
  4. Riess H, Kelley JM, Bailey RW, Dunn EJ, Phillips M. Empathy training for resident physicians: a randomized controlled trial of a neuroscience-informed curriculum. J Gen Intern Med. 2012;27(10):1280-1286. doi:10.1007/s11606-012-2063-z
  5. FAQS in Interventional Radiology. Vol 6. Society of Interventional Radiology; 2019.
  6. Kerr, R., Garvin, J., Heaton, N., & Boyle, E. (2006). Emotional intelligence and leadership effectiveness. Leadership and Organization Development Journal, 27(4), 265-279.
  7. Kane L. Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide. Medscape. https://www.medscape.com/slideshow/2020-lifestyle-burnout-6012460#2.
  8. Unal, Z. M. (2014). The contribution of emotional intelligence on the components of burnout: The case of health care sector professionals. Electronic Journal of Business Ethics and Organization Studies, 19(2), 27-34.
  9. Lopes, P. N., Grewal, D., Kadis, J., Gall, M., & Salovey, P. (2006). Evidence that emotional intelligence is related to job performance and affect and attitudes at work. Psicothema, 18, 132-138.
  10. Gray A. The 10 skills you need to thrive in the Fourth Industrial Revolution. World Economic Forum. https://www.weforum.org/agenda/2016/01/the-10-skills-you-need-to-thrive-in-the-fourth-industrial-revolution. Published January 19, 2016.
  11. Mullen C. Is emotional intelligence training a new workplace trend? The Business Journals. https://www.bizjournals.com/bizwomen/news/latest-news/2018/12/is-emotional-intelligence-training-a-new-workplace.html?page=all. Published December 28, 2018.