How Physicians Can Develop EQ

MAY 18, 2018
Heidi Moawad, MD
emotionalintelligence,emotion,empathy,eq Emotional intelligence has become such a valuable quality that few people have not heard of its benefits. Given that doctors interact with people in challenging interpersonal situations, it makes sense that a high emotional intelligence quotient (EQ) would be a prized skill for physicians to have. Before it was even given a formal scientific name, the idea of EQ was always recognized as one of the skills that provide people with advantages in life.

EQ is not the same as other important personal and cognitive abilities, such as analytical intelligence, charm, charisma or even sense of humor, although some would point out that those who have high EQ are at least average, if not above average, in the other measures of intellectual and cognitive ability. Some of the early writings about EQ pointed out the features and benefits but did not help those who with low EQ remedy the situation. So, an important question is—can doctors raise EQ if it is not an innate skill?

Developing EQ
It turns out that psychologists have identified several distinct traits of EQ, and that some of these traits can be improved—either by personal effort or through training. Peer-reviewed studies have shown measurable and lasting improvement in at least some aspects of EQ. Improving these skills can help tremendously in enjoying life, maintaining important relationships, happiness and efficiency at work, especially as a doctor. 

Understanding One’s Own Emotions in Medicine 
Understanding and recognizing feelings can be challenging for some doctors. The fear that a patient may not have an optimal outcome and the fear that you may have done something wrong are generally unacceptable feelings in medicine. Rejection from patients who don't agree with recommendations or who do not trust physicians can lead to defensiveness. 

In general, negative feelings like these are very unpleasant, but, according to experts in EQ, identifying the feeling and the precipitating cause is an important step in maintaining mental and emotional health. 

Empathy 
Empathy can be very difficult in the current healthcare environment—which is rampant in hostility, requirements and restrictions coming from diverse and competing interests. This causes many doctors to react defensively, interfering with empathy. When everyone is worried about not getting due rights, suspicion is raised and empathy suffers on many ends. 

While doctors are justified in feeling squeezed, patients still have illnesses that need attention and empathy. Recognizing that patients' feelings are almost always about themselves rather than about challenging the doctor can be difficult to remember in the current hostile health care environment. Doctors who remind themselves to have empathy, experience better doctor-patient relationships and satisfaction at work.

Managing Emotions 
Managing emotions is about keeping feelings in check. For new physicians in particular, situations that raise concerns about bad outcomes can trigger feelings of dread and fear, even leading to paralysis in making decisions. Exaggerated feelings that are out of proportion to the true threat of the situation are often related to other circumstances—such as similarities to a past bad outcome or an unfriendly coworker situation. 

Recognizing emotions is important, and managing any emotions that are truly unjustified or exaggerated can help prevent misery for a physician. Doctors who face paralysis when it comes to making medical decisions may resent or run away from heavy responsibility, shifting difficult decisions to others as much as possible.

Expressing Emotions 
EQ is not just about recognizing and shutting down emotions, it also requires distinguishing which emotions need to be dealt with privately, and which need to be outwardly expressed or communicated in some way. A non-complaint patient may cause frustration, but ignoring the issue and treating it as if it doesn't exist is not the right answer either. Explaining to the patient that it is time for a different approach or that there is no other equivalent medical therapy, may be necessary. Similarly, when you deem a patient's condition serious enough to require hospital admission, but the hospital balks due to cost, you need to calmly and confidently spell out the importance of the situation rather than ignoring your unsettled emotions. 

When EQ Doesn’t Come Naturally
While EQ does not come naturally to everyone, gaining these skills through deliberate practice can make a huge difference in one's life. One of the first emotional challenges that a person may face when effectively working on raising EQ is getting a response such as, "That isn't like you to be so nice (or polite, or sensitive, or calm etc)."

Perhaps the first exercise in EQ could be imagining and working individual feelings and responses to such a discouraging comment, rather than it being a setback.

REFERENCE

Emanuel EJ, Gudbranson E. Does Medicine Overemphasize IQ? JAMA. 2018 Feb 20;319(7):651-652. doi: 10.1001/jama.2017.20141.

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