THE EFFICIENT OPHTHALMOLOGIST

Put emotional intelligence into your practice

Our emotional cues can influence patient outcomes.

By Steven M. Silverstein, MD, FACS

As physicians, we have not only the skills to diagnose and treat physical maladies, but we have the power to “make the weather.” Of all we accomplish every day, setting the correct emotional venue of our patient’s visit may be the most important responsibility we have. We know intrinsically that physician empathy and emotional intelligence correlate to patient satisfaction and outcomes.

I propose that we intentionally build emotional intelligence skills into the fabric of our lives and practices.

DEFINING EMOTIONAL INTELLIGENCE

Over the last two decades, we have heard the term “emotional intelligence” grow from concept to discipline. First introduced more than 20 years ago by Peter Salovey, emotional intelligence is defined as:

“The ability to perceive, appraise, and express emotion accurately and adaptively; theability to understand emotion and emotional knowledge; the ability to access and/or generate feelings when they facilitate cognitive activities and adaptive action; and the ability to regulate emotions in oneself and others. In other words, emotional intelligence refers to the ability to process emotion-laden information competently and to use it to guide cognitive activities like problem solving and to focus energy on required behaviors.”¹

A growing body of published literature including well-respected academic research exists on how and why emotional intelligence is important. Medical schools now include emotional intelligence indicators in their admissions process.

BALANCE CLINICAL AND PSYCHOLOGICAL

Why has this gained so much attention? Isn’t emotional intelligence innate? The answer is yes and no. We maintain a delicate equilibrium with our patients, balancing our clinical skills, invoking our psychological skills, and displaying empathy – all within an often abbreviated patient encounter. We have a unique relationship with our patients and their families. They must trust us in treating their physical ailments while relying upon us to help them emotionally. As our patient encounters become shorter because payer pressures and overhead increases make them so, our emotional intelligence often gets sidelined.

Every now and then we need to take stock of the “weather” in our lives and in our practices. What is the emotional temperature? Daniel Goleman, in his book “Primal Leadership,” says great leaders drive emotions positively. He states, “The glue that holds people together in a team, and that commits people to an organization, are the emotions they feel.”² Great leaders truly influence the mood, and moods influence how effectively people work. This has no greater significance than it does in medicine.

PATIENT CONNECTIONS

We must work harder to be the emotional leaders in our practices and keep our emotional intelligence skills sharp. Creating an emotionally intelligent environment in our practice culture is the key to ensuring that emotional competence is the norm and institutionalized in our processes.

According to Paul Burcher’s article “Emotional intelligence and empathy: its relevance in the clinical encounter,” “… it is only in an organizationally supportive climate that emotional intelligence is translated into emotionally competent behaviors.” Medical education and clinical environments are antithetical to fostering emotional intelligence in physicians.³

The way physicians are trained – the intensity, long hours of residency, overwhelming work load – and then when in practice, the pressure on our schedules – is, in many ways, contrary to growing emotionally. Over time, it is easy to slip into the “business” of medicine and lessen our focus on our prime directives, including the emotional wellbeing of patients, staff and families.

Even in a brief office visit, our patients hone quickly on our emotional cues and we can, in an instant, either decrease or increase their stress – and influence outcomes. We must swiftly read our patients’ emotional states and respond in an emotionally competent way. We also need to be acutely aware of our own emotional state, and make adjustments appropriately.

MAKE AN IMPACT

In this outcomes-driven world in which we practice, let us remember that a primary indicator of patient outcomes and patient satisfaction is the level of empathy a patient experiences with his/her doctor. In Goleman’s research on emotional intelligence, he states that emotional learning is life-long. Emotional lessons, even the most deeply implanted habits learned in childhood, can be reshaped. We may have to reshape some of our thinking to improve the “weather” in our practices and in offices.

This process begins with your own awareness. What follows next is staff training so emotional intelligence will become integrated into your organizational structure, and hence into the fabric of your practice mission state. OM

REFERENCES

Steven M. Silverstein, MD, FACS, is a cornea-trained comprehensive ophthalmologist in practice at Silverstein Eye Centers in Kansas City, Mo. He invites comments. His e-mail is ssilverstein@silversteineyecenters