Inappropriate Assessments for “disruptive physicians” May Pose Risks

The JCAHO (Joint Commission) standards for physicians make a clear distinction between “disruptive physicians”, psychiatrically impaired physicians, substance abusers and/or sexual abusers. Unfortunately, some resources for “disruptive physicians” demand that all participants undergo a formal psychiatric examination that may include all of the following according Dr. Donna Yi, MD. of the Menninger Clinic in Texas: “Evaluation of disruptive behavior may require a multiplicity of assessments, including a psychiatric assessment, medical and laboratory work-up, addictions and trauma evaluations, psychological and neuropsychological testing, and brain imaging studies such as an MRI or even functional scans such as PET or SPECT examinations. Note that even negative findings can assist in establishing that disruptive behavior is not neurologically, but rather personality based, for instance”.

Physicians who are mandated to seek intervention for “disruptive behavior” must be careful in selecting a provider. If the physician is suspected of being psychiatrically impaired, it is reasonable for him or her to receive any or all of the assessments listed above. However, none of these examinations should be required for “disruptive behavior” unless the symptoms suggest psychiatric impairment or substance abuse.

When physicians are subjected to such examinations, it may become difficult or impossible to explain to a Hospital Credential Committees or Medical Licensing Board why these exams were conducted for behavior that is not considered pathological. A mandated psychiatric assessment places inappropriately referred physicians at risk of being entered into the National Practitioner Data Bank. Once a physician is listed in this data bank, it is almost impossible to get any information removed.

Available current research data does not indicate a significant relationship between “disruptive/angry behavior” and psychopathology. In practice, the largest number of referrals are surgeons who are burned our, extremely stressed with poor skills for managing impulse control, assertive  communication, stress management, empathy and/or interpersonal relationships.

Rather than psychiatric treatment, psychotherapy, psychotropic medication or some other mental health intervention, all of the three major providers of service for “disruptive physicians” that are listed below offer non-psychiatric interventions.

The Program for Distressed Physicians 


The CME program was designed as part of the ongoing mission of the Vanderbilt Center for Professional Health’s commitment to physician well being. We have titled the course “distressed” instead of disruptive since the basic behavior of these physicians results from internal factors that is obvious from the experiences we have seen in the physicians attending the course. 

The central theme for the course is to provide physicians with disruptive behavior a safe, confidential environment where they can learn with their peers about the origins and consequences of their actions. This environment must be conducive to open discussion in small groups with no more than seven and no less than five physicians in each group. The therapeutic modality is guided small group interaction. Each physician is given the opportunity to tell their story and confide their fears and hopes with other physicians in the group.

The Program for Distressed Physicians provides services in groups of 7 physicians each quarter for total of 27 physicians per year.

Anger Management For Healthcare Professionals Program

This course is designed to help those physicians and healthcare providers who have contributed to a disruptive working environment by way of inappropriate expression of anger. Conflict, stress and disruption in the hospital and clinic setting create low morale, heightened rates of staff turnover, and patient safety concerns.

The Anger Management for Healthcare Professionals program is a small, (6-8) participants), intensive and highly interactive three -day course taught by UC San Diego faculty from the Department of Psychiatry. Participant coursework in the form of self-reported inventories of mood and interpersonal conflict as well as reading is required.

The objectives and goals of this course include:

• Aiding participants to identify triggers in the workplace leading to disruptive behavior.
• Didactic instruction providing constructive tools and strategies to aid in diffusing and managing anger and conflict in an appropriate and professional manner including:

◦       Increasing Emotional Intelligence

◦       Empathy Training

◦       Transforming conflict into cooperation

• Practicing both behavioral and cognitive strategies, including coping mechanisms, leading to healthier communication and interactions in the healthcare environment.
• Developing a personalized plan of action (Commitment to Change)

PACE provides a dynamic training program that offers professionals an opportunity to obtain educational information and personalized assessment in a highly sensitive, supportive and confidential environment away from the workplace.

The Anderson & Anderson Executive Coaching for “disruptive physicians”

This is the largest program currently in existence for the assessment and coaching of “disruptive physicians. Services are available nationwide seven days per week with no limit on the number of referrals.

Services are provided either at Anderson & Anderson in Los Angeles or On-site, at the convenience of the physician anywhere in the United States. The Anderson & Anderson coaching for “disruptive physicians” uses a coaching curriculum based on Emotional Intelligence skill enhancement. This curriculum was designed in conjunction with physicians.

Each participant completes the Bar On EQ-i-2.0 Emotional intelligence Assessment that is considered the industry standard in emotional intelligence assessments worldwide. All training material is mailed to the participant in advance of the first session.

The Coaching is offered in two phases. The Bar On EQ Assessment is administered on-line prior to Phase One. Phase One consists of two days of assessment debriefing and skill enhancement coaching. All services are provided individually and are strictly confidential.

Phase two consists of twice monthly coaching sessions via phone over a 6- month period. At the conclusion of this six-month period, the physician completes the Bar On EQ Assessment again to determine the success or lack of success of the coaching.

In summary, Physician Well-Being Committees, Local, Regional and National Medical Associations should caution their physician members against taking risks that may unintentionally damage their careers such as information provided to The National Practitioners Data Bank based on inappropriate assessments for “disruptive behavior”. Such assessments are far more damaging than the “disruptive physician” label that fortunately is being changed to disruptive behavior.

 

 

 

 

 

2011 Developments in Professional Anger Management

The single most significant development in professional anger management during the current year is the emergence of Emotional Intelligence Assessment and Intervention as the accepted theoretical basis in most Anger Management Curricula in the United States.

A comprehensive Internet review combined with input from Certified Anger Management Facilitators indicate the following changes during the current year:

• The BarOn EQ -i-2.0 Emotional Intelligence Assessment is clearly the most recognized, most researched and most reliable assessment in emotional intelligence coaching and organizational development currently in use. The BarOn EQ-i-2.0 is now the official assessment for use by The American Association of Anger Management Providers as well as Certified Anger Management Facilitators.
• Courts in California increased its’ use of anger management sentences to include coaching for individuals, couples and parents. Family Law Courts joined Criminal Courts in using anger management professionals for court referrals.
• Psychiatrists, Psychologists and Psychotherapists recognized Anger Management based on Emotional Intelligence as the intervention of choice for impulse control.
• Healthcare Organizations nationwide moved decisively to adopt Emotional Intelligence based Anger Management Coaching for “disruptive physicians”.
• Finally, Organizational Development experts moved aggressively to endorse Emotional Intelligence based Anger Management training for business and industry relative to skill enhancement in Stress-Management, Self-Perception, Self-Expression, Interpersonal, Decision Management, Empathy and Impulse Control.

Based on these impressive development during 2011, it is projected that narrowly focused anger management curricula base on anger control alone will fade away during 2012.

George Anderson, MSW, BCD, CAMF, CEAP

Emotional Intelligence Coaching is excellent for increasing civility

An increasing number of states are requiring training in “civility” as a condition for licensure for Attorneys. The ideal intervention to satisfy this requirement is coaching or classes in Emotional Intelligence.

The Bar On EQ-i-2.0 Emotional Intellicence Assessment for each participant followed by skill enhancement in the 15 scales that are a part of this assesessment provides the base for increasing civility and emotional intelligence.

The five Composite Scales that are included in the coaching or training are Self-Perception, Self-Expression, Interpersonal, Decision Making and Stress Management.

These trainings can be customized to meet the needs of any organization.

George Anderson

Emotional intelligence is key to success

Kenneth J. Kleppel Ohio Lawyer, July/August 2007 “All learning has an emotional base.” —Plato

“Intellectual ability” is an important factor in predicting a lawyer’s success in practice. Recent studies, however, have shown that a resume packed with a stellar grade point average and law review experience is not entirely indicative of the capacity to practice law or even generate business. Rather, character, leadership, ability to relate to others and attitude—attributes that are indicative of the capabilities generally identified as “emotional intelligence”—are equally important. After all, most lawyers have IQs that allow them to graduate law school and pass the bar exam. Likewise, it is the experience you acquire during the first years of practice that will ultimately matter much more to your career than the ability to craft an essay as a 20-something law student. Given this basic level playing field in intellectual ability, the emotionally intelligent lawyer is more likely to achieve professional success than one who has less understanding of, and control over, emotions.

Following a pattern set by the business world for more than a decade, law firms have begun to view the emotionally intelligent candidate, clerk, associate or partner with increasing favor. In acknowledging the importance of emotional intelligence in the internal process of recruiting and hiring associates and ultimately advancing junior and senior associates to partner status, these firms have not become “weak” but, rather, “wise.” This article will explain why by providing a primer on the practical definition of emotional intelligence, and then introduce examples of how lawyers can use the psychological processes associated with emotional intelligence to develop as professionals.

What is emotional intelligence?

Emotional intelligence—first introduced by Edward Thorndike in 1920, defined by Peter Salovey and John Mayer in a series of papers published in the early 1990s, and popularized by Daniel Goleman in three best-selling texts published throughout the past decade—describes an “ability, capacity, or skill to perceive, assess, and manage the emotions of one’s self, of others, and of groups.” In its basic form, this school of thought holds that traditional cognitive intelligence alone cannot ensure success at work and in life. Rather, those who ultimately succeed are in control and command of their emotions, restrain negative emotions such as anger and doubt, and focus on positive feelings such as optimism and confidence.

While competing interpretations exist—Salovey and Mayer, for instance, frame the concept as intelligence in the traditional sense and other theorists place it in the context of personality theory—Goleman’s definition, which formulates emotional intelligence in terms of performance, is the most popularly accepted today. Specifically, Goleman groups emotional intelligence into four clusters of psychological skills: self-awareness, self-management, awareness of others and social skills. Self-awareness implies an

awareness of what one feels in certain situations and includes self-confidence and selfassessment of strengths and limitations. Self-management identifies distressing emotional effects and includes self-control, adaptability and the ability to prevent emotional impulses. Awareness of others is how one deals with others and includes service

orientation, organizational awareness and an understanding of the effect that words or actions will have on someone else. Social skills builds on these three categories and embodies one’s ability to sustain a quality relationship including leadership, communication and the ability to influence others so as to preserve a relationship. The difficulty lies in applying this technical psychological framework in a practical manner to our performance as attorneys in various practices of law.

Using emotional intelligence to improve our professional development

Becoming leaders in the profession

By mastering the psychological skills set forth by Goleman, we enhance our ability to lead and positively impact how clients, juries, judges, colleagues, opposing counsel, etc., view us. Those who acquire leadership positions in firms often achieve them for reasons other than their ability to lead—they have extra time, bill the most hours or are simply the most senior. None of these reasons, however, necessarily relate to the actual ability to lead. The emotionally intelligent attorney can fill this gap. First, observe recognized leaders in the profession and emulate the behavior that makes them successful (awareness of others). Second, determine those skills that will be most helpful in responding to the likes and dislikes of your clients and superiors in the firm, and then prioritize these competencies accordingly (self-awareness and selfmanagement). Finally, consciously develop these skills and participate in community service, networking activities and other efforts that allow us to interact with peers on a professional and personal basis (social skills). By developing the ability to lead, we can begin to use emotional intelligence to manage our negative emotions and ultimately improve our work performance.

Dealing with negative emotions to improve performance

Fear, anxiety and anger operate as a double-edged sword. On one hand, they motivate us to work harder and succeed. On the other, they can cripple our efforts to perform. As is often the case, we experience insults, unfair practices and obstacles that interfere with achievement of our goals. In the high-stress environment of law firms, these challenges can disrupt our ability to not only lead, but also to perform. Because it is necessary for lawyers, especially those in leadership positions, to tolerate ambiguity and handle risk taking, a strong grasp on emotional intelligence can not only help us, but also empower

us, to deal with fear, anxiety and anger, and turn them into positive emotions. Again using Goleman’s framework of psychological skills, we can become aware of the conditions that trigger these emotions, manage ourselves to best respond to these conditions and ultimately develop a long-term plan for a constructive resolution. It is the attorney that most effectively manages stress, and responds to fear, anxiety and anger— not necessarily the one with the strongest grasp of the rules of evidence or legal

technicalities—that can ultimately navigate through the many challenges and obstacles that a law career presents. The emotionally intelligent lawyer knows how to deal with unruly partners, colleagues and clients, accepts constructive criticism and overcomes such worries as “will I make partner?”

Pleasing the client and generating business

Service to clients is at the core of the practice of law. A lawyer’s ability to communicate and relate to others—social skills in Goleman’s paradigm—plays an important role in his or her practice. While strong work product and results are certainly important to satisfying a client’s business needs, an emotionally intelligent lawyer who can effectively communicate with, relate to and understand the client may be the key to pleasing the client and earning or retaining that client’s business in the first place. Today, competition for new clients in the Cleveland market, for example, is as intense as ever. Any comparative competitive advantage can help sustain and grow business as law firms continually adapt their business development strategies to what works. We serve people, and accordingly, need people skills to be successful. For example, take rainmakers who are able to bring in new clients with their charisma, likability and trustworthiness—all characteristics indicative of emotional intelligence—rather than their law school class rank. Ultimately, the law encounters emotion at all turns. From divorce to employment discrimination, alternative dispute resolution to trusts and estates, the law deals with emotion at some basic level. It is drafted by legislators and enforced by judges and jurors, who, being human, react to matters before them in a very human way. We can thus train ourselves to become active listeners and more empathetic counselors—skills that will enable us to best understand, communicate with and respond to our clients.

Start hiring emotionally intelligent associates

Law firms must now take the initiative to recruit and hire emotionally intelligent associates. While the best and brightest candidates should still be hired, an understanding that intellectual ability is not the only criteria for true “brightness” is essential to the hiring process. Accordingly, hiring partners should train interviewers to observe emotional intelligence and how candidates behave in certain scenarios. The results could be given as much weight as grades, law review and moot court experience. Psychologists have developed objective tests to measure this behavior. These tests include the Mayer- Salovey-Caruso Emotional Intelligence Test, a measure involving a series of emotion based problem solving items; the Emotional Quotient Inventory, a self-report examination designed to measure a number of constructs related to emotional intelligence; and the Emotional Competence Inventory, a feedback tool where the score is a reflection of feedback from management, peers and underling employees. These formal examinations simply measure behavior, personality and attitude, and, now that we can define it, emotional intelligence. Businesses have long used behavioral-based

Copyright © 1999-2009 Ohio State Bar Association. All rights reserved.

Emotional Intelligence for business performance

Anderson & Anderson are pleased to offer organizational training courses in leadership, empathy, stress management, self-awareness, self-control, communication and emotional intelligence. Our training courses are developed with and delivered by subject matter experts in the emotional intelligence areas mentioned above.

Recent studies conducted by the Consortium for Research on Emotional Intelligence in Organizations suggests the economic value added by training and development geared toward improving emotional intelligence in the workplace increases organizational effectiveness. The focus of future businesses will be on developing a good company, where ethics, leadership, civility and morale are the driving forces behind products, services, ROI, and profit.

The Anderson & Anderson curriculum is customized  to meet your needs using industry and company specific examples and organizational terminology. Such courses may be tailored for HR professionals in your company to improve their effectiveness in dealing with employees.  We may provide your company with group training in anger management, stress management, customer service, leadership, and communications. Based on our professional experience, training is most effective with groups of 6 to 25 people. Anderson & Anderson deliver specialized training in any of the areas above, at your location.

Services Offered:

• On-Site Trainings: 2, 4 and 8-hour trainings for      employees. Topics include: Anger, stress, communication, and emotional      intelligence.
• Executive Coaching/Anger Management: With a focus on interpersonal      relationships, empathy, communication, decision making, stress tolerance      and emotional intelligence. We currently provide these services for a      number of Fortune 500 Companies as well as major hospital chains. Coaching      can be provided in our provider offices or on location nationwide.

• Accelerated Anger Management Classes for Managers, Executives and Line Staff: Personalized 8-10 hour programs with client workbooks for fast results. Pre and Post Bar On EQ-i-Emotional Intelligence Assessments are included.
• Anger Management Classes for employees: Classes for employees who exhibit evidence of stress, anger or inappropriate aggression at work. Studies have shown that aggression and violence in the workplace increases absenteeism, reduces productivity, lowers morale and increases a company’s liability.

For a partial list of our clients, visit our website: http://www.andersonservices.com/client_list.html

Bar On EQ -i-2.0 Emotional Intelligence Assessment now available On-line

Anderson & Anderson, APC is now Certified by Multi Health Systems to administer and interpret the new Bar On EQ-i-2.0 Emotional Intelligence Assessment. This instrument is a must for coaches, psychotherapists, HR Managers and Organizational Development Professionals interested in the latest, most effective instrument for assessing Emotional Intelligence competencies.

Assessments of individuals and small groups can be competed On-line, twenty-four hours a day, seven days a week. Coaching, team and staff development using the Bar On EQ-i-2.0 will be offered by Anderson & Anderson On-site nationwide. This is an excellent tool for use by Physician Well-Being Committees relative to “disruptive behavior” as well HR Managers from any type of organization.

A sample of recent Anderson & Anderson trainings offered include:

• Emotional Intelligence for Leadership
• Emotional Intelligence for Physicians
• Emotional Intelligence for “disruptive behavior”
• Civility Training for Attorneys
• Leadership for Change

Presentations can be customized to meet the needs of most organizations.

Please contact George Anderson at georgeanderson@aol.com or 310-207-3591 for more information. To review a copy of a Bar On EQ-i-2.0 client assessment, click here: http://www.cgrowth.com/pdf/JaneDoe_Client_CG.

How to find a job in 2011: pay attention to emotional intelligence

This month’s question focuses on things job seekers should keep an eye on in 2011 (trends/tools/hiring practices).

Trends

Companies are looking for people who are qualified and those who make a direct connection between their skills and what the employer wants. It’s still difficult (although not impossible) to transition to a new field. It’s about demonstrating that you can solve the employer’s problems and that you can “fit” into the company’s culture.

To be successful in a job hunt, you will not only need to demonstrate an association between what the employer wants and your skills and accomplishments, you will need to be able to tell your story in a way that makes it obvious you have the emotional intelligence/emotional quotient (EI/EQ – or soft skills) to get the job done.

A quick definition is in order. Here is one that I like and is easy to understand from Mike Poskey, VP of Zerorisk HR, Inc:

Emotional Intelligence..is defined as a set of competencies demonstrating the ability one has to recognize his or her behaviors, moods and impulses, and to manage them best according to the situation.

The Sodexo (one of the largest food services and facilities management companies in the world) blog reminds readers that “businesses that will succeed in the 21st century will be the ones that allow employees to bring the whole of their intelligence into the work force – their emotional and intellectual self. Not only does this impact morale, but productivity increases, too.” A recent study from Virginia Commonwealth University shows that “high emotional intelligence does have a relationship to strong job performance — in short, emotionally intelligent people make better workers.”

If you are still not convinced that you need to start paying attention to emotional intelligence, my friends over at Talent Culture recently shared information suggesting that “companies are really investing in assessing and developing emotional intelligence to improve the bottom line:”

• According to Whole Foods CEO John Mackey, for leadership positions, emotional intelligence is more important than cognitive intelligence.
• At PepsiCo, executives identified as emotionally intelligent generated 10% more productivity and added nearly $4 million in economic value.
• At Sheraton, an emotional intelligence initiative helped increase the company’s market share by 24%.
• L’ Oreal realized a $91,370 increase per head for salespeople selected for EQ skills. The group also had 63% less turnover than sales staff not part of the EQ program.
• Coca-Cola saw division leaders who developed EQ competencies outperform their targets by more than 15%. Division leaders who didn’t develop their EQ missed targets by the same margin.
• The US Air Force reduced recruiter turnover from 35% annually to 5% annually by selecting candidates high in emotional intelligence. Total cost savings of $3 million per year on a $10,000 investment.
• Hallmark Communities sales staff who developed emotional intelligence were 25% more productive than their low EQ counterparts and EQ was more important to executive job performance than character, strategic thinking, and focus on results.

(Side note: Be sure to visit Talent Culture’s useful Twitter chat – #TChat on Tuesdays from 8-9 pm Eastern time.)

With all of this research on emotional intelligence, it is time for job seekers to start paying attention. Your job search materials must competently tell your story and illustrate that you not only have the capacity to get the job done (that is, you have the specific skills, training and accomplishments), but that you have the ability to fit in and to bring that talent to the next — emotional — level.

BE the person who is willing to go the extra mile. Show, don’t tell. Maybe that means you hold the door for somebody behind you on the way to the interview. Or, that you let someone take the parking space you both were eyeing. Who knows – you might have been angling your potential new boss out of her space!

Obviously, there’s much more to this than simply being courteous– emotional intelligence is complicated and difficult to pin down, but one aspect is being aware of other peoples’ needs. Look at your network. Do you have one? Are you a connector? Do you try to put people in touch with each other, just for the sake of doing it? If so, you are SHOWING that you care about people – that you are a team player.

What would your boss or colleagues say about you? Do they think only about your competence, or will they comment on your great attitude, how you lead by example and show everyone the same respect? Are you the one who pitches in and stays until the end, or are you running out to handle personal matters? Everything adds up, and how you behave will shape how people see you.

Think about it – do you have the necessary skills to fit in and get the job done? Do you agree that skills such as being able to cooperate and be a team player are crucial for success in the next decade? Stay tuned for more about this topic, including how to improve your EQ and what thought leaders say about the subject!