NEW ORLEANS—After performing an otoscopy and writing a diagnosis of “obvious middle ear effusion,” Ellen M. Friedman, MD, had a wake-up call when the referring physician called her condescending. “He told me on the phone that perhaps it was obvious to me because I had been at Harvard, but it wasn’t so obvious to him,” said Dr. Friedman, professor of otolaryngology-head and neck surgery and director of the Center for Professionalism at Baylor College of Medicine in Houston. The referring physician added that if Dr. Friedman hadn’t been quite so condescending, he would have sent her a lot more patients.
Explore This IssueNovember 2019
While taken aback by the experience (she had been writing this diagnosis in the way her mentors had taught her to write it), Dr. Friedman took this physician’s feedback and dropped the word “obvious” from her written diagnoses from that point forward.
Her lecture, “IQ Got You Here. EQ Can Get You There,” presented at the Women in Otolaryngology luncheon as part of the American Academy of Otolaryngology–Head and Neck Surgery (AAO–HNS) 2019 Meeting, held September 15-18 in New Orleans, discussed the importance of high emotional intelligence (EQ) in a work setting and how communication skills, including thoughtful word selection, can play a part in building or undermining relationships with colleagues and patients.
Dr. Friedman defined IQ, or intelligence quotient, as a number used to express the apparent relative intelligence of a person, adding that IQ is innate. She defined EQ as the skill to feel, communicate, recognize, manage, and understand emotions. Whether you are born with a high EQ or not, she said, it’s something that can be changed. And it’s not something that goes hand in hand with the high IQ that may have landed a person in medical school, an otolaryngology residency, or a fellowship.
“Some of the most brilliant people we know have a lot of emotional intelligence problems,” Dr. Friedman said. “EQ is not really on the same gene as IQ. The good news is, whereas IQ is innate, EQ can be learned.”
Emotional intelligence is also something that can make or break a physician’s practice.
Emotional Intelligence Focuses on Careful Communication
According to Dr. Friedman’s presentation, miscommunication among medical staff contributed to 80% of serious medical errors, and the average 500-bed U.S. hospital loses $4 million a year specifically as a result of communication inefficiencies. Miscommunication can even cost residents and physicians their jobs when they share misplaced humor or political opinions.
Dr. Friedman spoke of an incident in which the Cleveland Clinic fired one of its residents this year after discovering a series of anti-Semitic tweets she had posted as an undergraduate, including one joking about her intention to purposely give Jewish patients the wrong medicines. She shared another case about a Texas hospital resident who’d had an especially challenging shift in the ER. “He sent an email to several friends saying, ‘This ER is horrible and I’ll give anyone $2,000 to blow the place up,’” she said. What the resident thought was a joke was taken as a legitimate terrorist threat, which triggered an FBI investigation and nearly cost him his residency.
Communication comes in three forms: face to face, via telephone, or electronic (email, private message, or text). In face-to-face communication, Dr. Friedman said, the words we speak comprise approximately 7% of our communication efforts, whereas tone of voice comprises 35%; the rest is nonverbal, expressed in our body language. In other words, how we stand, sit, gesture with our hands, and express feelings on our faces says more than our words.
When we yawn, stretch, and roll our eyes—either purposely or subconsciously—a person with a low EQ does not pay attention to those visual cues and simply plods along. Someone with a high EQ, on the other hand, understands when you are bored, annoyed, or otherwise disengaged and likely pauses and considers how to regain your attention. “If you have a low EQ, you ignore the visuals,” said Dr. Friedman.