The world of medicine is evolving so rapidly that those members of the supposedly self-centered Generation Y (born during the 1980s and early 1990s) who constitute most young physicians will find themselves unsuited to the profession and its institutions.
Excellent technical skills and medical knowledge are no longer enough to satisfy patients and employers, argues Ayalla Reuven-Lelong, a management graduate of the University of Haifa. Emotional Intelligence (EI, or EQ for Emotional Quotient), compassion, identification with patients, reinventing oneself every few years and being a leader are only some of the requisite qualities physicians will have to learn.
Reuven-Lelong’s creative, 264-page Hebrew book Lihiyot Rofeh Ba’Mea Ha-21: Masa Lehamesh Yabashot (Shaping the 21st-Century Physician: A Journey to Five Continents)
describes the transformation of the medical field that is already upon us and will become a clear fact of life in the years to come. The author, who runs a Haifa-based company called EQ-EL, has invested much effort at the city’s Bnai Zion Medical Center, turning it into what she claims was the first hospital in the world to inculcate in its employees how to boost their emotional intelligence. The project began after a chance meeting a few years ago with Bnai Zion director-general Dr. Amnon Rofe, who realized the importance to his staff of what she had to teach.
Rofe noted that when Bnai Zion began the process, it “always paid attention to the emotional intelligence of our staff, even though we didn’t call it that. The attitudes toward our patients and their families were always supreme in our minds, as were good relationships among our employees. Still, there was a need to invest in formally improving their well-being and boost positive feelings. We always selected our medical departments not only for their medical skills but also the way they relate to patients and colleagues.”
REUVEN-LELONG, who has been working in EI for 16 years, ought to know, as she has introduced her techniques through courses to dozens of organizations and companies, including banks. In addition, her company has led research at the Technion’s Rappaport Medical Faculty to produce a profile of EI for doctors in the 21st century. That effort blossomed into this volume – a must-read for all physicians in hospitals and community clinics and for all hospital directors and department heads and senior Health Ministry officials.
Rofe even wrote an endorsement of the book in a three-anda- half-page introduction, in which he warns about the high speed of change in the medical world.
“Managements of health organizations and a significant part of professionals in the field are only beginning to internalize the fact that the rules of the game are changing. Ayala Reuven Reuven- Lelong succeeded in summarizing in her book all the changes in the medical world and the main things that are missing in training its future leadership and the unambiguous need for personal and organizational development of abilities in the field of EI.”
It involves the ability to monitor one’s own and other people’s emotions, discriminate among different emotions and label them appropriately and use emotional information to guide thinking and behavior: self-awareness (the ability to know one’s emotions, strengths, weaknesses, drives, values and goals and recognize their impact on others while using gut feelings to guide decisions); self-regulation (controlling or redirecting one’s disruptive emotions and impulses and adapting to changing circumstances); social skill (managing relationships to move people in the desired direction); empathy (considering others’ feelings, especially when making decisions); and motivation (being driven to achieve for the sake of achievement).
EI principles include respecting oneself while understanding and accepting one’s strengths and weaknesses; assertiveness and defending personal rights and values in a socially acceptable, non-offensive and non-destructive manner; self-actualization and trying to improve oneself; stress management; respecting others’ feelings; social responsibility; and developing and maintaining mutually satisfying relationships that are characterized by trust and compassion. The American journalist insisted that these skills are not inborn, but that they need to be practiced and developed to improve one’s performance.
The hospital director recommends the book to all hospital staffers, including nurses, technicians and auxiliary staff as well as physicians. He goes on to describe the volume as easy to read and digest, as well as easy for doctors to identify with the problems posed. Reuven-Lelong provides the tools for thinking and self development.
On the back-cover flap, Prof. Eliezer Shalev – dean of the Technion’s Rappaport Faculty of Medicine and a prominent gynecologist – writes that “all of us will have… to venture out on a journey that will not necessary be in our comfort zone. The aim will be to reach as close as possible the figure of the ‘whole physician’ – a doctor who loves people, is a smart user of medical technology, who conducts research and is innovative, has emotional intelligence, is an excellent clinician and teacher who arouses inspiration and who will turn into a model for emulation in the profession.”
Shalev urges medical faculty members to “go on this journey, without which we will not be able fully to help our students to truly be the doctors of tomorrow. Every doctor will be able to easily find himself in the story and obtain additional insights for his personal and professional development.”
MEDICAL PROFESSIONALS tend to be a conservative lot who only change their routines (if at all) when the need to do so is tangible and incontrovertibly proven.
The EI advocates claim that individuals with high EI have greater mental health, outstanding job performance and more effective leadership skills. While there remain skeptics, in recent years scientific studies have been published that help characterize the neural mechanisms of emotional intelligence, as well as techniques that measure EI accurately.
Reuven-Lelong presents an apparently fictional head of a hospital obstetrics/gynecology department named “Dr. Yonatan Segev” who believes in the technique.
Voicing Reuven-Lelong’s explanations, Segev explains that patients in Israel (and around the developed world) will soon be using their smartphones to monitor their health and inform their doctors via sensors if something goes awry. Computers will diagnose diseases early and more competently than doctors. Patients, informed by the Internet, will have amassed a lot of updated information about their conditions that even doctors are not aware of.
“One thing is sure,” notes Segev. “Doctors will be able to do things that computers cannot – create relationships with the people they treat, show compassion, listen, hold hands in difficult moments, give complicated advice and carry out those very challenging diagnoses that even a robot with the world’s most sophisticated algorithm cannot do. The digital doctor will supply accurate performances, will check for errors and save hospitalization, but the human doctor can touch the patient and encourage him, actually treat and not just handle papers.”
These suggestions probably make the average doctor confused. Medical students have over the decades been taught not to get emotionally involved with patients, especially those who are terminally ill, so they can go on to the next patient without being broken. Hold patients at arm’s length, they were constantly advised. Now Segev urges them to hold patients’ hands.
It’s impossible for any physician to keep abreast of the 1,500 articles published daily in a total of 4,000 medical journals, Segev notes, but patients waiting to see the doctor can learn the latest in laymen’s terms from Wikipedia and be impatient with clinicians who are less updated than them.
Patients will most need a sympathetic, caring medical caregiver. Because of delayed retirement of doctors (due to a chronic shortage of MDs), there are now four generations of physicians in hospitals, each with different knowledge, personalities, outlooks and needs. Even the youngest will need to be retrained to cope with the new realities.
SEGEV MEETS in his office with a physician named “Lior” who has excellent medical knowledge and skills but complains that he has been turned down when he applies for higher positions. Segev suggests that he meet with “Marva,” the hospital’s canny head of human resources, who encounters Lior’s skepticism about doctors showing “qualities of softness and concern” to patients.
Finally, the young doctor – worried about his lack of advancement and his future at the hospital – agrees to take time off from the hospital and go on a (fictional) journey with a trainer named “Rona” to five “continents.” This changes his life and mindset. In fact, Rona says that they are boarding a plane to visit “Mindset-land,” where they meet different kinds of people in parks and other locations who identify Lior’s conceptual and behavioral difficulties.
The island of Emotional Quotient is Lior and Rona’s most important destination, but there are four others: The I-21 continent, where a doctor learns to identify opportunities for growth, reinvent himself periodically and develops ideas for winning values; the Thinking Patterns continent, where the doctor hears how to continuously learn clinically, emotionally, innovatively, technologically and as a leader; the Whole Brain continent, where the p h y s i c i a n functions analytically, methodically, strategically and creatively and promotes good relationships with colleagues, underlings and patients; and the continent of Focused Leadership, where the physician connects to mentors and sponsors while coping with challenging situations in a positive way while ensuring his/her own well-being.
People that the two meet on their journeys through the continents seem omniscient, able to discern what type Lior is and what his hangups are. They zoom in on them and note his increasing sensitivity, EI and yearning to be a leader and innovator.
Skeptical, conservative doctors may call all of this mumbo jumbo, but by the end of the journey, Lior and probably many who are receptive to reading Reuven-Lelong’s book, becomes a fervent advocate of the approach. “These things are no longer jibberish for me,” Lior concedes.
Rona gives him the opportunity to use a special device to envision what he will be doing in five years. Lior is amazed to find himself a senior doctor, well rounded, emotionally aware, well liked by colleagues and medical students and feeling good about himself.
WHEN HE “returns” to his hospital department, he is a changed man and doctor. Segev notes that although he had some doubts about his willingness to change, Lior has passed with flying colors. He even gets along better with his wife “Hadas” and their two children.
“If in the past I felt unenlightened in the new world. Now I know I had the tools to succeed there. I began to think with enthusiasm about the challenges before me, and I felt how everything was coming together. Without doubt, I am able to contribute much more to my team and the department where I work, to succeed substantially and bring the field forward. Feelings of meaningfulness and satisfaction filled me and I wake up and go to work with enthusiasm and new strengths. In fact, the journey has only just begin, but without doubt I have all the necessary equipment to succeed.”
For those readers from the Old Guard who nevertheless remain unpersuaded by the fictional voyage, Reuven-Lelong offers a long series of questions and answers at the end about how to change mindsets. Dismiss at the peril of being left behind.