Emotional intelligence in practice

Emotional intelligence is a crucial skill for today’s health care professionals. It can help you communicate effectively, resolve conflicts, cope with stress, and foster empathy and compassion. In this PermanenteDocs Chat, hosted by Alex McDonald, MD, we explore the importance of emotional intelligence in health care.

Pamela Honsberger, MD, and certified emotional intelligence trainer, shares her insights and tips on how to cultivate and enhance your emotional intelligence. Discover practical strategies to improve your communication, empathy, and stress management skills in a health care setting.

Guest

• Pamela Honsberger, MD, Southern California Permanente Medical Group

Podcast transcript

Transcript is autogenerated. Although edited for clarity, it should not be considered an exact replication of the podcast and may also be updated as needed.

Alex McDonald, MD: Hello and welcome everyone out there, wherever you may be watching, listening or tuning in from, and welcome today’s PermanenteDocs Chat. I’m your host as always, Alex McDonald I, and today I’m excited to talk with Dr. [Pamela] Honsberger, who is an ob-gyn and director of Physician Development in Orange County and a certified emotional intelligence trainer. Dr. Honsberger, welcome to the PermanenteDocs Chat. Thank you so much for being here today.

Pamela Honsberger, MD: Thanks for having me. This is really exciting.

AM: Today we’re talking about emotional intelligence and why it’s important for physicians to know what it is and have a little bit of training where they can learn more to increase these skills, which are going to benefit us. Let’s jump right in. Dr. Honsberger, tell us a little more about who you are and what you do.

PH: I’m a family physician, [and] I practice women’s health, but I’ve mostly spent the last 15 years in physician development and support and physician leadership development. That sparked my interest in my own personal growth, which led me down the road of emotional intelligence. I also now sit on our elected board, which I love being a part of. But really my passion is all things physician support and development.

AM: Let’s start with the basics. What is emotional intelligence?

PH: So emotional intelligence, the concept of it has been around for a very long time. And in fact, based on the work of Daniel Goldman really way back when and the importance of emotional intelligence in leadership and success. Now since then, it’s even expanded more in just emotional literacy and things like that. But the basic concept of emotional intelligence is that you have enough self-awareness to recognize your emotions and emotions and other to then really navigate relationships, both the relationship with yourself. That’s the self-management idea. I like to say if I’m getting triggered, I might need to step away, but also in the relationship management piece and how we work with others. So I decided to get certified so I could use some of the work with our physicians and our groups and build on it. But that’s the basic idea around emotional intelligence. And there’s a lot of research that we like to follow, leaders who motivate us, inspire us, and often we see them having a little bit higher emotional intelligence. But the good news is you can also build it. There are tools, there are tricks if you need to strengthen one part of the muscle. There’s four components real quick, and then I’ll let, the first one is self-awareness. The second one is self-management. And then in the broader scope there’s social awareness and then there’s relationship management. And those are kind of the four quadrants of emotional intelligence.

AM: So it sounds like certainly a skill which is absolutely critical for physicians not only interacting with patients, but also interacting with the myriad other members within the healthcare team, especially in sometimes very high pressured life or death potentially situations. Would that not be an understatement

PH: That you pegged it? Because what really, I do believe medicine is filled with a lot of empathic physicians and healthcare teams, and that’s the component of the social awareness. But we also might need some of the other pieces of it to have a longer career in that longevity. So I’ve also kind of explored the linking around compassion, where that comes into play and the many, many relationships that we every day are dealing with, whether it’s our patients, the team, each other, things like that.

AM: Okay. Now is this something that is specifically innate? Is it something you mentioned you can kind of develop it and work on it and grow your emotional intelligence in certain areas, but it seems like, I’ll just be honest, some people tend to have more kind of innate emotional intelligence than others. Is that accurate?

PH: The idea that you can build on it really is. It’s all relative. So we all will get a different, if we take the assessment, if you decide to take the assessment, you’re going to get a percentage in each of those four quadrants. So you may be really, really high in self-awareness and but it also might mean you’re the first one to set boundaries and walk out of the room maybe a little prematurely. So depending on what percentage you are, that’s what you get to decide to work on. So in my case, relationship management has always been the one that I need to continue to grow and build on because some of it comes down to setting some boundaries or loosening our boundaries so you can develop it. And I’ll give you a quick example. If social awareness is one of the lower percentages, and for us as physicians, we all are low in general on these tests because we’re used to being very high on tests, but it’s really all related to each percentage is for social awareness. One of the tools you can use is you can go to the movies and pay really a lot of attention to the emotions and naming the emotions and things like that. So that’s a really simplistic low hanging fruit. But I do love to recommend getting out and going to movies if you have the opportunity.

AM: What I’m hearing you saying is we should all go to the movies.

PH: Exactly, but there’s other things you can work on and the book, and if you do the actual assessment, it does have specific things you can be doing with the idea that if you took the assessment again in six months, you might see a little bit of a change in that percentage.

AM: Now is this something that is formally taught to physicians? Is this something that we sort of just get learned through osmosis in our training? How is this built into the practice of medicine?

PH: Well, it’s interesting. We’re so fortunate, at least here in S-C-P-M-G, we have a really robust leadership development program as well as when associates join and we’re on our pathway to partnership that we do use some of these programs, which is why I got certified so I could have the materials, but we were doing it anyway and it can be foundational. So I think that’s one of our unfortunate opportunities here within our group because I would almost guarantee that in the outside world, they just don’t have the same robust support and development for our careers and our profession.

AM: Sure, that makes perfect sense. We have a question in the chat here that I’m going to kind of a little bit of a segue, but it’s on topic here. So how can doctors kind of gain more skills regarding emotional intelligence without being certified or becoming certified given how busy everyone is?

PH: So you can just Google the emotional intelligence 2.0 book. I have no skin in the game there, but that’s what you can use and there’s an assessment in it as well as all of the things to understand it better. You take the assessment and it gives you your percentages, and then you can focus on some of the areas. So absolutely, there’s other programs people can go to and things like that, but really that’s kind of the easiest to just start by taking a look at ourselves.

AM: And are there different tools and strategies that it provides for working on different aspects if you’re lower in one quadrant versus another?

PH: I only remember I get to go see movies, but actually there’s a lot of other 25 tips for each area that you can work on. The relationship management part’s been interesting to explore more because it’s led me down the path this might resonate with some of the people of really what does it look like to have good boundaries. We talk a lot about compassion fatigue and many other things that, I know you’ve done some podcasts on those different topics of burnout, but really when you explore the relationship management part, that is where you can actually end up growing a little bit in your ability to have healthier boundaries. And I think that’s a unique and essential skill for us for a long and sustainable career.

AM: Yeah, absolutely. Perfect segue into my next question here is regarding just maintaining our joy and practice as physicians. Joy, gratitude, optimism, all these pieces definitely can seem to have a positive upward spiral to help us be healthier, happier physicians or can have unfortunately, a negative downward spiral. And how does emotional intelligence and physician wellbeing and joy and practice, how do those kind of coalesce in what are some things that we can do individually and collectively to cultivate a positive environment and positive emotional intelligence?

PH: It really is a kind of beautiful foundation, and especially if you understand really what your strengths are in this space, and then also what can get you in trouble. The self-management part. For some we have to make decisions, am I going to engage in this right now? Am I in a good space to do it? Should I really be sending that email right now? So I’ve had to work a little bit on Thatm, a very passionate person, and things are very urgent most of the time to me in my head.

But developing this idea of is this the right time and what do I need to be doing to be in the best place to engage and have conversations or problem solve with others? So in terms of the joy and the gratitude, we all went into a profession, not necessarily a business. I didn’t go into a business and yet we are in a business. I think by being able to really explore more around what our strengths with our relationships with each other and how we support each other as colleagues, I think that does enhance our joy. It’s kind of why we’re here. And sometimes it can get lost and for, and for me in my past, I’m a little better now. I did have to realize that I didn’t have to fix and engage in everything that I sometimes have to hold back. And that’s the insight from some of the emotional intelligence

AM: Work. I have two your comments that made me think of two things specifically that I can give examples in my own career is one, I am a very socially connected individual for those of you don’t know. And Covid was the worst thing ever because I never got to interact with any of my colleagues. Some of my colleagues started in the middle of Covid, and even if they worked down the hallway, everyone was so isolated. We didn’t have those micro social interactions, just a smile or a hello in the hallway. And those little interactions really, I felt that those really valuable for me both personally and professionally just to maintain my own happiness and wellness as an individual. And I don’t think I realized how important those little micro interactions were until they were gone, quite frankly. So that’s kind of one example I can give. And then the second piece, oh, darn it. I lost it. Ah, that’s all right. It’ll come back to me probably two in the morning when I’ll wake up and remember what my question was.

PH: I love that you pointed out that about the micro dosings of things like time with colleagues. The other thing I think we need to just point out the elephant in the room. I know you and your background a little bit about me, but we have all these other responsibilities. We have these kids at one point a mom who was ill and you can’t be everywhere. So finding those things that you need for me was I needed a little bit of alone time, so I would go walk for 30 minutes, not respond to people, things like that. So that’s another piece of this self-awareness is what do we need to do to get through work and life as it’s all blended

AM: Together? Yep. No, absolutely. It seems now with these little devices and computers in our pockets, we can are always s on and we can’t ever step away. Sometimes it can be very draining. So I think that’s an important piece to make sure we do set boundaries for ourselves and our work and our families sometimes too. Exactly. What are some ways that as individual physicians, we can help foster emotion intelligence amongst other physicians and other colleagues? What are some things that you do both within your professional role there within Orange County as well as just kind of individually, what are some things we can do to help foster greater emotional intelligence amongst our colleagues?

PH: Yeah, it’s a great question and it makes me think of really the one word of curiosity. In medicine, we are a hypercritical group, we’re hypercritical of ourselves,

And thank goodness we are because we have a really noble profession that there’s often a lot at stake, but sometimes we are just as hypercritical in other spaces where we don’t need to be. So getting curious, why are they acting that? Why are they responding that way? And by really just modeling that empathy, even if it’s, I think there’s a book about how to love a porcupine or something like that, even if you feel like you want to pull away because the energy is not the same as yours. Get closer, get curious. And often I think that’s where you learn a lot more about what people are feeling, what they’re doing. And really that does then develop a better relationship.

AM: So

PH: I think that’s our opportunity.

AM: That reminds me of a phrase or a framework my colleagues likes to use about when you’re dealing with a difficult patient or a difficult colleague or person, instead of thinking to yourself, gosh, what’s wrong with this person? Shift the framework to what happened to this person. And I think that’s part of that curiosity of why are they acting this way? What’s motivating them? And I think that framework can help us be less kind of oppositional and more collaborative with anyone in our

PH: Lives. All relationships,

AM: Totally. All relationships. And so find that little up.

PH: Good point there, because I think I started my work really in the clinician patient space and how to enhance communication and connection. And then I had to shift a little, because I’m sure we have many on the call here that are actually over connectors, and we are fortunate now to be able to have some tools that may help us with our documentation, things like that. But something has to give because you can’t over connect. I used to learn things about patients that really, I didn’t need to know their niece was getting married in Vermont next year, but it’s what I enjoyed about my practice, but it’s not always a sustainable space, so you’re totally right. Sure.

AM: Yeah, and it’s almost like you’ve been reading the script, and that actually dovetails perfectly to my next question is again, emotional intelligence is this highly personal interaction with ourselves and with colleagues and patients. Now we have the advent or the explosion of technology, whether it be the electronic health record or now augmented intelligence, which is now finding its ways in more and more interactions in the exam room, in email, in communication. How do you envision technology either benefiting or creating new challenges when it comes to emotional intelligence with ourselves individually and with our colleagues?

PH: It’s a great question. I was thinking about this because I am testing out some of our ability to have the virtual scribe idea, but I think there’s a sweet spot. First of all, I think we always need that human connection, but some of the things that we’re testing out or that will be tested out in medicine are actually really helpful. They’re working on in basket AI being able to take out new results. But there’s a phrase that comes up that says, hello, Dr. Honsberger, I will be going into your in Baskett right now. I hope you have a good day. I’m like, that Falcon, I know it’s a bot or whatever, but so I think there’s that sweet spot. I don’t ever want us to lose the connections both with our patients and our colleagues, but I think we have to embrace technology and figure out ways to make it a little bit easier.

AM: And I think that physicians need to be kind of on the ground floor as this technology rolls out so we can make sure that it works for us and isn’t additional one additional challenge or patient challenge when it comes to technology. I’ve been fortunate enough, I tend to be an early adopter of technology. I’ve been using some of our augmented intelligence tools for documentation, and I walk in the room and I ask the patient, if I can use this technology to record our visit, put my phone down, have a conversation with the patient, look at the patient, not even touch the computer. And really, for me, that really builds connection and collaboration and it’s a so much more enjoyable experience than being tied to the computer and not even looking at the patient. So for me as an individual, that augmented intelligence and artificial documentation listening tool has been really, really cool and has helped me kind of enjoy the practice of medicine more.

PH: And I’m a late adopter. I’m also That’s okay. That’s okay. I’m not stubborn. I’m a learner. And I do believe for those of us who might be over connectors and things, that it is something that will be a game changer. So I just started using it and I love it and I’m going to continue to grow with it because I do think it’s a good part for a more sustainable kind of long, long-term career. I don’t think we planned things out as well like we did in our training. And so I spent a lot of time with physicians talking about what does it look like in five years for you in 10 years and things like that.

AM: Sure. Yeah. Now, you touched on this a little bit earlier, but I want to kind go back to it a little bit and talk about that balance of professional and personal life just to prevent burnout and compassion fatigue and a lot of the challenges we all face every day As physicians, what are some concrete tools or recommendations you have for colleagues who are struggling with that kind of work-life boundaries and separations and that kind of balance?

PH: Yeah, I think so. The root really is a little bit of our perfectionism, which is good until it’s not.

And again, remember, my family is not rating me on emotional intelligence. This is all work because my scores might be way lower at home. Often what happens with our balance, something has to give. So the first thing I would say is just first of all, get to know yourself a little bit. I think even just taking an assessment like this or something that to understand more about where you are and being able to say what you need. So for me, I know I need to get out and take a walk. That sounds silly, that sounds, but I’m very clear that if I don’t get it in, I’m going to be not the same person in either space. And we could do a whole podcast on self-compassion and going that road too, because there’s a lot of linkage there. But being able to say, what’s the one thing you need to get through your day, whether it’s at work or at home, that is a really strong skill, and it is part of the self-management too. After you get to the awareness part,

AM: I’m making a note to myself to do a future podcast on self-compassion, because I think that’s an absolutely critical topic, and we will try not to go down that rabbit hole at this visit.

PH: So,

AM: Well, this has been phenomenal. I love this topic. I love this conversation. You’ve done so much work in this area. We could go on and on, but again, we try to keep these pretty short and high yield. And so last question, my favorite question, what makes you most proud to be a permanent day physician?

PH: Yeah, so I feel I’ve been here so long. It feels that way. I trained here as well. I am so proud of our Permanente partners and all the physician leadership and stuff is my passion. But my colleagues, our colleagues, we didn’t know it was going to be this adventurous, I don’t think, when we went into medicine, and I wouldn’t want to be anywhere else.

AM: No, that’s a great way to end the chat. So thank you so much for joining your insights and your expertise and just really appreciate your time and all the work that you do.

PH: Thanks for having me. I appreciate it.