If You Turned a Doctor “Inside Out”

No one Inside_Out_(2015_film)_posterwould blame you for wondering if we doctors have feelings. We’re pretty good at hiding them. With the research of people like Peter Salovey and Daniel Goleman in the 1990s, the business community realized that concepts like emotional intelligence (EI) correlate strongly with performance, and particularly with effective leadership. Nearly 20 years later, as healthcare strives to become more patient centered, we’re learning that when doctors express feelings like empathy and compassion, patient outcomes improve. It’s logical to assume that healthier patients bring cost savings. The welfare of both patient and industry may well depend on the individual behaviors of physicians.

Inside, we doctors share the same universal emotions: joy/happiness, sadness, anger, fear, and disgust (and on some lists, surprise). However, because it’s easier to think than feel, many doctors forget how important it is to communicate – or they simply don’t know how. Doctors can learn a lot about what it’s like for patients to navigate the ups and downs and twists and turns of healthcare. One way is by looking through the emotions of an 11-year-old girl named Riley in Pixar’s animated movie, “Inside Out.”

Where do emotions live? If you’ve seen “Inside Out,” you learned they’re headquartered in our minds. In the case of doctors, this means emotions are fighting for space with a vast amount of medical knowledge. Although lying in the operating room we wouldn’t trade that knowledge for anything, doctors can provide optimal patient care with the benefit of both their IQ (the rational) and EI (the emotional). Knowledge in partnership with emotion provides exceptional results for patients.

Emotional intelligence enables you to understand and manage your own emotions as well as the emotions of the people around you. If you have a high level of EI, you are aware of what you and others are feeling, what the emotions mean, and how they are affecting others.

As we see in Riley, all of our emotions are necessary and helpful, depending on the circumstance. In the case of doctors, this might mean feeling and expressing:

  • Joy after successfully delivering a baby, or completing a successful strategic planning retreat.
  • Anger at a coworker who does something “stupid,” or at yourself when something goes wrong for a patient.
  • Sadness after an unexpected and sudden death, or after not being chosen for the chair position.
  • Fear when treating someone dying in front of your eyes and you don’t know how to fix it, or during a performance review.
  • Disgust at your inability to fix the healthcare system when you know it’s harming people, or eating lunch in some hospital cafeterias.

What’s the difference between a low EI and high EI doctor? If we peered down into an operating room, as they often do in TV shows and the movies, we might witness an assistant handing the surgeon the wrong instrument by mistake. Low EI doctors would immediately shout angrily at the assistant, making every member of the surgical team uneasy – and more likely to make a mistake themselves as a result. High EI doctors would calmly correct the mistake and talk with the assistant privately after surgery to find a solution that would prevent the mistake from happening again. In this case, the doctor’s high level of EI would probably save the team and the patient. Patient-centered care thrives on positive, cooperative relationships all around.

Low EI doctors are fond of assuming a god-like stance through the intimidation of everyone around, a proven relationship blocker. “Inside Out” director, Pete Docter (yes, a coincidence), says he “is not the type to swoop in with stereotypical director bravado – ‘stand back, I’ve got this,’” according to a recent interview in the NY Times with Brooks Barnes. “I’m not the typical take-charge, silver-backed gorilla director,” he says, which is an almost perfect description of the personas of doctors who thrive on instilling fear in patients and nurses alike.

I believe doctors with low EI are more likely to cause something called the “nocebo” response, the opposite of the placebo effect. The nocebo response occurs when patients experience negative interactions with their doctor or feel a lack of understanding or acceptance from them. This can create anger and stress that actually worsens their illness.

Studies like these make us realize that healing is all about efficient, respectful teamwork between doctor and nurses and other professionals, and their partnerships with patients. Incivility at any level can cause medical errors; long term it can compromise our immune systems, contributing to myriad health problems like cardiovascular disease, cancer and diabetes. Effective teams and partnerships depend on the emotional intelligence of participants, particularly the doctors who are leading a patient’s care. Emotional intelligence opens interactions up to the benefit of everyone. How we treat one another matters: at work, at home and in the hospital or doctor’s office.

Better human relationships are reason enough to incorporate EI into healthcare. There are also financial benefits in a system whose long-term viability depends on reducing costs. Recent studies show that physician EI can positively affect leadership; teamwork; and clinical, financial and organizational outcomes. EI influences patient outcomes and organizational success. Pepsi learned their high-EI executives increased ROI (return on investment) by 1000%. What are the possibilities for healthcare if EI is universally practiced?

Healthcare is uniquely fraught with complexity and anxiety on many levels. Patients need the knowledge and intellect of their doctors. They also need to feel their doctor’s genuine understanding and support. As Riley finds out, joy and sadness, along with all the other emotions, are partners in making authentic connections with other people. In the case of healthcare, connections that can heal, and save the system.

Emotional intelligence may not be innate. It can be learned. “Inside Out” is a good place to start – and take your family with you.