Practicing Self-Awareness: A Pathway to Success

Posted on Tue, Jul 21, 2015
Practicing Self-Awareness: A Pathway to Success

By Jeff Slepin, MD, MBA, FACEP

Your visions will become clear only when you can look into your own heart. Who looks outside, dreams; who looks inside, awakes. - C.G. Jung

Hospital-based physicians have advantages and disadvantages over “traditional” medical staff physicians or sub-specialists. One of the most significant disadvantages is the potentially tenuous career stability in terms of practice venue.

During 15-plus years in practice management and consulting, I have witnessed the careers of many clinically competent physicians having been detoured or derailed by lack of self-awareness. The result sometimes led to a “career change opportunity” – a term with a positive connotation that actually reflects an involuntary transition to another practice setting. These involuntary transitions continue in today’s practice environments, marked by ever-increasing expectations of patients, family members, nurses and administrators. In many cases, these “opportunities” could be prevented simply by having greater self-awareness – better insight into how words, actions and inactions are interpreted by others with whom physicians interact on a moment-to-moment basis.

The traditional preparation for medical practice generally has not equipped physicians with the skill set needed to adapt to the rapidly changing environment of healthcare delivery in the United States. The increasing supply/demand imbalance for service delivery, shifts in patient demographics, advent of electronic health records, scrutiny of quality, and increasing regulations are some of the primary factors which influence societal expectations in the transition to a customer-focused delivery system. Physicians completed medical education and post-graduate training feeling empowered, emboldened, and in some cases omnipotent. Yet they had received little or no training in communications skills, conflict resolution, organizational behavior, mindfulness, and many other disciplines afforded to those working in other sectors of the economy. The benefits of such training would contribute to physicians’ ability to accurately “read” the effectiveness of messages being sent through verbal and non-verbal communication. Today’s most effective and (perceived to be) successful physicians have excellent insight and realistic assessments of their own abilities – their strengths and weaknesses, their effect on others, and the skills that needed to be developed or improved.

What is self-awareness? What is required to achieve it?

Self-awareness is the capacity for conscious perception of one’s personality, behaviors, habits, emotional reactions, motivations and thought processes. Having heightened self-awareness helps physicians make better choices. It improves their understanding of how they may reaction to difficult situations and ultimately assists in modifying undesirable reactions. Self-awareness includes such things as core beliefs about oneself and life, strengths and weaknesses, fears and passions, likes and dislikes, and what is important in a medical career and why.
One of the most important aspects of self-awareness that requires focus in today’s fast-paced, challenging practice environment is knowing one’s “triggers” – those inputs that initiate a visceral response characterized by a perception (usually visual or aural). These triggers often are followed by bodily response and sensations, finally leading to an adverse reaction – usually perceived by others in a negative light. These visceral responses are well-developed conditioned patterns of input and response through biochemical and anatomical pathways.
Consider the scenario of a “difficult” or hostile patient or family member. Antagonistic words or actions may naturally elicit a defensive or hostile response. The reaction is characterized by sensory input, which triggers one or more emotions. The emotional reaction is followed by the release of stress hormones (epinephrine and cortisol) with an increase in pulse, blood pressure, shunting of blood from the extremities, and muscle contraction (for example, in the muscles of the face, forehead, shoulders and rhomboids). These involuntary responses are often quickly followed by a verbal or physical response, often defensive or possibly offensive, that reflect poorly on the physician. These are normal responses to stress, not indicative of pathology. Think of the last time this happened – and you may not have been aware of the occurrence until after the fact or until someone else brought this to your attention.
The purpose of this discussion is to stimulate interest in exploring your inner-self and reaction to stress. A deeper self-awareness can help you improve your recognition of the “triggers” that may cause an adverse interaction. Such recognition may help thwart the cascade of events that could lead to a patient or administrative complaint and, more importantly, reduce your level of stress.
How to Tame Your Triggers
Understanding your inner-self, your personality traits, and stress response will give you the confidence to identify some of your “triggers” and how to modify your response into a more constructive, mindful approach. A simple strategy to deploy when triggers are activated is to “stop, pause and breathe (take a deep breath), assess, think, and respond.” This will hopefully interrupt well-established, conditioned patterns of response to stressful situations. The conscious application of this or similar techniques may enhance the confidence and ability to handle the rigors of the practice environment.
Practice! Participate in an exercise in which a planned stressor is applied and will activate your stress response. Identify the emotional and physical responses, and develop the ability to “stop, pause and think, breathe, and (then) respond” in a more constructive manner.
Finally, this exercise is only one of many techniques and is not a one-time process or event. It is a life-long focus that extends beyond your professional activities. Future articles will delve into this topic in greater detail and hopefully stimulate deeper insight, professional satisfaction and personal happiness.

M. Jeffrey Slepin, MD, MBA, FACEP, is a residency-trained, ABEM-certified emergency physician who has been a Regional Medical Director for EmCare since 2003. He attended Emory University and completed his medical education at the Medical College of Virginia. Following his residency at the University of Florida Health Sciences Campus in Jacksonville, he practiced in Virginia and Florida. He obtained his MBA at the College of William and Mary Graduate School of Business prior to joining EmCare.

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