Whether doctors realize it or not, their types can influence every step of
their medical careers. Should I be a doctor? How do I get through medical
school? What kind of practice should I join? How can this care team work better?
Type can help with all these questions.
Patricia Williams, ENFJ, an M.D. who frequently consults in medical settings,
finds type a lifesaver for medical residents (including interns). Besides
helping the new doctors understand and support each other, type helps them
manage the enormous stress. For example, type can help intuitives understand why
they felt overwhelmed in the first year of medical school when the heavy
information load requires a lot of sensing skills.
"T/F differences are also very important," says Williams.
"Feeling residents take it very hard when a patient doesn't do well,
whether or not it's their fault. They are often good at empathizing with
families but may find it very hard to break bad news. Thinkers can relate the
bad news but may not be comfortable handling the emotional reactions."
Williams adds, "J/P can be critical too. While Ps may need to learn some
J skills to get through medical school, they have a huge advantage as interns
because they multi-task easily and aren't as easily upset by the constant
interruptions and change of focus required as interns. Js get very stressed out
by this constant shifting of gears."
Type even affects reactions to "rounds", a fast interactive
teaching process biased towards extraversion. The introverted intern can be
overwhelmed by the rapid fire questions and frequent impatience of the attending
physician. Extraverts can be frustrated if an introverted attending physician
doesn't communicate his or her thought process.
Williams also uses type in hospital settings, often to improve teamwork and
change management. In one psychiatry unit, the predominantly introverted staff
realized that they were good at one to one communication with patients, but they
needed to work on sharing information in staff meetings and other group
settings.
At a community hospital, Williams was asked to present type to help
physicians and key administrators struggle with major changes. In a morning
session Williams introduced type and prepared participants to use type awareness
to facilitate talking about tough issues later on. As is often the case in
community (vs. academic) hospitals, the physicians were widely distributed in
type depending on their practice areas, but were primarily SJs and only
one-quarter NTs. The non-medical senior management group (administrators) were
predominantly INTJ. This type information gave people a new perspective about
why physicians disagreed among themselves and why physicians and administrators
looked at things so differently. People were able to see why changes were
threatening to some physicians and exciting to others.
The feedback about type was astounding. Physicians and administrators both raved about the session. Type had set the tone for the afternoon, lightening things up so the group could open up and accomplish much more than expected.
With the increasing burden of managed care, type is being used to help some
large medical practices understand their dynamics and improve teamwork.
Waite Maclin, ENFJ, a Portland, Maine consultant has found the temperament
profiles of the specialty practices he works with to be amazingly consistent -
mostly NT physicians with a smattering of NFs and SJs and support staffs which
are overwhelmingly SJ. "This creates a predictable dilemma," says
Maclin. "The support staff simply wants to do their duty and anything that
gets in the way of that (unnecessary change, confusion, mixed signals) causes
great stress. They want a strongly hierarchical, well ordered system. "
"Picture them working for largely NT physicians who embrace complexity,
creativity, and change. The doctors expect support staff to function with
minimum direction. Yet maximum direction is what the SJs need. Feeling SJs also
want to be appreciated, not a strength for NTs. Extraverted staff members can be
further alienated because they want more interaction than the introverted
doctors provide."
Once they understand type, both doctors and staff can see that differences of opinion within the practice are natural and not oppositional. Criticism can be seen less personally because it is couched in terms of type.
Maclin is often called in by the Practice Manager who runs the business side of the practice and can see the damage of a team that isn't working effectively. Meeting with the Practice Manager and the Head Physician, he explains how type can impact this practice's problems and how it has been used effectively by other practices. If the Head Physician supports type, this usually pushes others to get on board.
Maclin tries to introduce type first to the physicians because this sends a
message to others that the process is important. Since physicians can be
skeptical about self-awareness activities, Maclin introduces the MBTI as a
well-researched theory and instrument. He shares the original research,
subsequent studies, and pertinent articles about type. (See Overcoming Physician
Resistance on p. 4.) He also suggests easy ways for doctors to act with type in
mind: being patient with questions, taking a minute to chat during a coffee
break, telling someone they did a good job, or just learning a person's name.
One physician admitted sheepishly that he had never even entered the
accounting department. Another became aware that he only knew the names of staff
members with whom he worked closely. Only in the session did they realize the
impact these things might be having.
In working with a cardiology practice of 11 doctors and 41 staff, Maclin
first held two evening sessions with the doctors, followed by a day-long session
for support staff. Support staff usually welcome such initiatives, although they
have concerns about airing negative feelings. At the end of this session, Maclin
had participants list actions that would "make this a better practice and a
better place to work." He then put the list in an anonymous typed form and
analyzed its themes before sharing it with the physicians.
For the cardiology practice, getting everyone together took a year to
arrange. The second of the two evening sessions was made more informal by a
casual hotel setting with food. True to both type and status, the SJ staff
showed up on time and the primarily NT doctors drifted in from their hospital
rounds. Maclin was able to diffuse resentment by relating these behaviors to
what is more important to different temperaments (punctuality for SJs and
accomplishment in their craft for the NTs).
At the meeting, staff and doctors worked in temperament groups to identify
what their temperaments contribute to the practice. "Why should others in
the practice be glad we are here?" In addition to explaining differences
between the dominant SJ and NT temperaments, the reports of the NF and SP groups
highlighted some contributions others had never thought about.
Since the staff felt the practice needed a vision, a mission statement was created in the joint sessions and later in a joint committee with input from everyone. Not only did the SJs have their roadmap, but it had come from a truly joint process.
To type practitioners, applying type to patients would seem a natural focus
for a practice learning about type. Williams knows of one pediatric oncologist,
for example, who is looking at how type might be used to manage the stress of a
family coping with childhood cancer. But with limited resources, most practices
spend their time applying type to teamwork and practice efficiency.
So, for the time being, when you see Type?: ________ on a medical questionnaire, it will probably still mean blood, not psychological type.