American Association for Physician Leadership

Emotional Intelligence: Three Pivotal Points for Effective Physician Leadership

Farzana Hoque, MD, MRCP (UK), FACP, FRCP


Mar 7, 2024


Volume 11, Issue 2, Pages 32-35


https://doi.org/10.55834/plj.7357727642


Abstract

In today’s demanding healthcare environment, physician leaders must learn to make well-formed decisions and avoid being misled by their emotions. Research has shown the significant effect of emotional intelligence (EI) on the job satisfaction, influence, and leadership potential of physicians. Although emotional intelligence is not solely an innate trait, it is a skill that can be cultivated through intentional practice.




Physician leaders set the culture of the team and organization. The leadership qualities of physician supervisors have a crucial impact on individual physicians’ wellbeing, satisfaction, and organizational success.(1,4,5)

A study published in JAMA found that physicians’ perception of personal and organizational values was associated with their immediate supervisors’ leadership behavior.(1,2) Our emotions drive our behaviors, and our behaviors drive our performance, which is a strong determinant of our success and our failure.

As physicians, we often face situations that require us to make life-or-death decisions; however, we must remain cautious of the consequences. Failing to channel emotions during stressful situations can negatively affect patients, teams, and the organization. It is here that physician leaders demonstrate how they lead themselves before leading others. Their actions profoundly reflect their potential and credibility.(6) Demonstrating emotional intelligence (EI) plays a pivotal role in physician leadership.

The term EI refers to our capacity to recognize, rationally analyze, and regulate our own emotions rather than impulsively reacting to a situation. Discussion of the foundational principles of emotional intelligence first appeared in the 1930s and continued to develop until the 20th century.(3)

Nevertheless, it wasn’t until 1990 that psychologists Peter Salovey and John Mayer made a significant contribution by publishing their groundbreaking article “Emotional Intelligence” in the journal Imagination, Cognition, and Personality. In this work, they defined emotional intelligence as “the capacity to monitor one’s own and others’ emotions, differentiate between them, and employ this knowledge to guide one’s thoughts and actions.”

In 1995, with the release of Daniel Goleman’s book Emotional Intelligence: Why It Can Matter More Than IQ, the concept gained widespread popularity.(3) A study involving interviews with 10 internal medicine chairs identified EI as the most crucial factor contributing to their success.(1,3) The study respondents also shared instances of failed leadership and high turnover resulting from a lack of emotional intelligence.

A systematic review of physician leadership and emotional intelligence emphasized that emotional intelligence is vital to physician leadership development throughout their careers.(1,3,4) Emotional intelligence is associated with higher job satisfaction and lower burnout rates among physicians.(4)

Three key factors of emotional intelligence for effective physician leadership are:

KNOW YOURSELF IN AND OUT

“Knowing yourself is the beginning of all wisdom.”

— Aristotle

Self-awareness is a vital aspect of emotional intelligence, encompassing a deep understanding and acceptance of all aspects of us, including those aspects that may be challenging to acknowledge. Individuals who have self-awareness tend to experience greater fulfillment, more confidence, and increased opportunities for advancement.(1) Self-aware leaders acknowledge emotional triggers, biases, and personal strengths.

Self-reflection complements and nurtures self-awareness. For example, when faced with a negative performance evaluation, an employee who asks “How can I improve?” instead of dwelling on “Why did this happen?” demonstrates a proactive commitment to finding solutions rather than engaging in self-destructive reflection.

Using 360-degree feedback helps identify blind spots and biases, but it’s unnecessary to seek feedback from everyone. Seeking input from individuals who genuinely care about our success and wellbeing increases our self-awareness.

A physician executive experienced a significant moment of self-awareness when a colleague pointed out his habit of wearing the same suit during meetings with surgeons where negative performance reviews were discussed. This new insight had a profound impact on him.

Although learning from our missteps can be challenging, it is an ongoing process throughout our lives. Accepting responsibility for our mistakes empowers us to find the courage to learn valuable lessons.

Each day presents us with opportunities to change our habits, much like the compounding effect of interest. At times, when we may be overly self-critical, forgiving ourselves of our errors allows us to view them as opportunities for growth.

The reality is that we cannot always control other people’s emotions, actions, and words; however, credible leaders take responsibility for their own emotions, actions, and words. Self-awareness is the pillar of emotional intelligence. If we cannot lead ourselves, we cannot lead others. Knowing ourselves empowers us to think rationally, capitalize on our strengths, and address our weaknesses.

BUILD AND MANAGE YOUR REPUTATION AS AN ASSET

“It takes 20 years to build a reputation and five minutes to ruin it.”

— Warren Buffett

In today’s digital age, the world of clinicians is profoundly interconnected. Our reputation precedes us wherever we go. While building a reputation takes time, it can be tarnished in a matter of minutes. Negative experiences tend to be remembered and shared more frequently than positive ones. A strong reputation can open doors. Physician leaders require intentional actions to establish and uphold a positive reputation.

Self-management refers to our ability to maintain effectiveness by controlling disruptive emotions, particularly during high-pressure situations. It is often the difference between exceptional physicians and those who leave a negative impression.

When we face distressing emotions like anger, our brain’s limbic system immediately generates a reaction. For example, if you receive an email from your boss that you do not agree with, your reaction could be to send an email that expresses your frustration. In contrast, if you tap into EI and use your pre-frontal cortex, the logical part of your brain, you will take a brief pause that allows you to consider the impact of a negative response on your professional relationship with your boss (see Figure 1).


Figure 1. Disruptive emotions trigger instant limbic system reactions, while emotional intelligence (EI) empowers thoughtful responses.


Reactions are typically driven by emotions and tend to be shortsighted, while responses are guided by knowledge, logical reasoning, and a balanced consideration of emotions, enabling us to see the bigger picture. The goal is to be proactive rather than reactive (see Figure 2).


Figure 2. The key differences between reaction and response.


One of the most effective ways to self-manage during heated moments is to take a brief pause to regain composure.(7) Failure to do so may result in saying or doing something that could damage a reputation. Acknowledge that stressful moments will inevitably arise. Self-management can establish the reputation of a composed and collected physician leader.

People’s perception shapes their reality. When developing a focused reputation, pay attention to how individuals perceive themselves in your presence. Equally important is recognizing the difference between our intentions and the actual impact they have on others. For example, sometimes our behavior may be interpreted as aggressive by those around us. While we can’t always control how others perceive us, a thorough understanding of how people perceive our behavior and objectives can help build a favorable reputation.

NURTURE YOUR RELATIONSHIPS

“The quality of your relationships determines the quality of your life.”

— Tony Robbins

Physician leaders who want to establish credibility must have knowledge and a strong network of professional relationships. One person cannot handle everything on their own.

While expertise and knowledge are essential, it is equally important to cultivate meaningful connections and build a network of trusted colleagues.(8) This combination of “what you know” and “who you know” allows physician leaders to not only demonstrate their competence, but also leverage their relationships to collaborate, seek guidance, and stay informed about advancements in their field.

Physicians who perceive themselves as solitary healers often fail to take collaborative approaches and struggle with the concept of teamwork. Our workforce is now more diverse than ever, and it’s important to recognize and understand the cultural differences and expectations of coworkers from different backgrounds.

One of the most impactful methods for cultivating and nurturing professional relationships is by addressing individuals by their names. Names serve as identities, often with social and cultural implications. Including a person’s name in conversation shows respect, recognition, and consideration for the ongoing discussion.(9)

A prime example of this principle in action can be seen in Starbucks, where they make a point of using customers’ names, fostering a sense of belonging that contributes to their success in terms of revenue and brand reputation.

Learning the correct pronunciation of an individual’s name extends beyond mere courtesy; it represents a pivotal step in building an inclusive workplace culture that emphasizes psychological safety and a feeling of belonging.

Researcher Jim Collins in his book Good to Great emphasizes the importance of having the right people on board for achieving success. When it comes to recruiting new team members, it’s vital to not only consider their skills, but also ensure they align with the values and culture of the team. Retaining exceptional performers requires understanding their internal and external motivations.

Noted business consultant and writer Peter Drucker said “Culture eats strategy for breakfast,” emphasizing the profound impact of organizational culture on strategic initiatives. The way leaders respond during crises, listen to their employees’ concerns and ideas, and manage conflicts plays a pivotal role in setting the tone of the organization’s culture.

Active listening nurtures positive personal and professional relationships. By actively listening, leaders learn from those on the frontlines, gathering valuable insights into innovative problem-solving approaches and identifying barriers that need to be overcome.(1,4)

As human beings, we are inclined to judge others by their actions while we give ourselves the benefit of the doubt. Recognizing that none of us is perfect, we should stop judging others for their minor mistakes and accept the fact that imperfections are a natural part of the human experience. Striving for perfection may be an ideal, but it is important to acknowledge that it is not a realistic or attainable goal. In recognizing our own limitations, we must also acknowledge that our bosses, co-workers, and stakeholders are not infallible either.

Excellence in our professional lives can be achieved through networking, but it is essential to keep in mind that these relationships must be of mutual benefit. A fruitful professional relationship results when both parties contribute and derive value from the connection. This reciprocity fosters a sustainable and fulfilling professional network that can enhance personal and career growth.

LEGACY OF LEADERSHIP

The journey toward establishing a legacy of leadership begins from within and radiates to our surroundings. Emotions hold a pivotal role in shaping our words and deeds; EI is a foundational skill for personal and organizational advancement.

In rapidly evolving, contemporary healthcare, physician leaders must have skill sets to manage, adapt, and advance in their professional careers. EI empowers them with indispensable instruments to channel their leadership potential effectively, particularly in critical situations. Through the cultivation of emotional intelligence, physicians can evolve into exceptional leaders, amplifying their impact and effecting positive change in patient care.

References

  1. Hoque F. Leadership & Professional Development: Emotional Intelligence Strengthens Leadership Presence. J Hosp Med. 2023;1–2. https://doi.org/10.1002/jhm.13158

  2. Stoller JK. Developing Physician-Leaders: A Call to Action. J Gen Intern Med. 2009;24(7):876–878. https://doi.org/10.1007/s11606-009-1007-8

  3. Childs S. The Emotionally Intelligent Physician Leader. 2022. Tampa, FL: AAPL; 2022.

  4. Mintz LJ, et al. A Systematic Review of Physician Leadership and Emotional Intelligence. J Grad Med Ed. 2014; Mar;6(1):21–31. https://doi.org/10.4300/JGME-D-13-00012.1

  5. Hoque F. The Power of Emotional Intelligence for Hospitalists. The Hospitalist. February 1, 2023;17–18. https://www.the-hospitalist.org/hospitalist/article/34099/career/the-power-of-emotional-intelligence-for-hospitalists/

  6. Shanafelt TD, Wang H, Leonard M, et al. Assessment of the Association of Leadership Behaviors of Supervising Physicians with Personal-Organizational Values Alignment Among Staff Physicians. JAMA Network Open. 2021;4(2):e2035622. https://doi.org/10.1001/jamanetworkopen.2020.35622

  7. Hoque F. Leadership & Professional Development: The Power of Pause. J Hosp Med. 2024;1–2. https://doi.org/10.1002/jhm.13284

  8. Lee T. Turning Doctors into Leaders. Harvard Business Review. April 2010.

  9. Panwar R. Why Getting Someone’s Name Right Matters. Harvard Business Review. January 2022.

Farzana Hoque, MD, MRCP (UK), FACP, FRCP

Farzana Hoque, MD, MRCP (UK), FACP, FRCP, is an associate professor of medicine at the Saint Louis University School of Medicine, St. Louis, Missouri.

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