Emotional Intelligence and Physician Wellness

Emotional intelligence (EI) is the ability to recognize and manage one’s own emotions and the emotions of other people. ¹ It involves the ability to be aware of one’s own emotions, the ability to control emotions and apply them to various tasks including problem-solving and thinking, and the ability to manage emotions including regulating one’s own emotions and affecting the emotions of other people (eg, cheering them up or calming them down). Intuitively, many of us recognize high EI as beneficial, but there are relatively few data confirming this intuition. One good study investigated the relationship between EI and resident well-being. ² Although the investigators did not gather data on practicing physicians, it is reasonable to speculate that they might be similar.

Various aspects of resident well-being have been studied more extensively than the well-being of practitioners. Among surgical residents, for example, a burnout rate of 60.3% has been identified, along with emotional exhaustion and depersonalization. ² Depression rates among residents and practicing physicians have been reported from 22% to 50%. ^{3 -5} Moreover, it has been established that the risk of suicide in male residents is 1.5- to 3.8-fold greater than age-matched and sex-matched peers in the general population, and the successful suicide rate for female residents is 3.7- to 4.5-fold higher. ^6,7

Lin et al studied surgical residents in a single program. ² They measured EI with the Trait Emotional Intelligence Questionnaire–Short Form, and they used the Dupuy Psychological General Well-Being Index, the Maslach Burnout Inventory, and Beck Depression Inventory–Short Form to evaluate resident wellness. Correlations provided very interesting insights. Emotional intelligence was found to be a strong predictor of residents’ well-being. Residents with high EI did better in residency than those with lower EI scores. High EI scores correlated with psychological well-being. They also correlated inversely with depression, emotional exhaustion, depersonalization, and 2 parameters of burnout.

The study by Lin et al not only provided these observations but also confirmed the high prevalence of burnout and depression among surgical residents. Eighty-two percent of the residents responding met criteria for burnout, and the emotional exhaustion and depersonalization scores were disturbingly high. These numbers were higher than the reported burnout rates for surgeons in practice (28%-48%). ^4,6 This suggests that some of the adverse factors affecting physician wellness may change with circumstance. It is also possible that they can be changed with interventions that increase EI. Since it seems clear that approximately one-third to one-half of surgical residents (otolaryngology residents were not studied specifically) meet criteria for depression, and since resident suicides continue to occur (as do suicides among practicing physicians), it seems appropriate for us to be concerned about all factors that might predict emotional difficulties and to seek information on all interventions that might mitigate them. In Lin’s study, EI was the only significant predictor of burnout, depression, and psychological well-being. ²

Emotional intelligence is associated with “noncognitive attributes that help individuals perceive and regulate emotions and in turn, cope effectively with emotive situations, such as environmental stressors or interpersonal relationships.” ² It is a significant predictor of physical and mental health in numerous populations. It has been shown to protect individuals against mental health abnormalities including depression and burnout ^{8 -11}

For otolaryngologists, when we interview potential residents, associates, or perhaps even physician extenders and nurses, we tend to rely on interview impressions and previous past performance. Perhaps it is time for us to research whether EI is as important among otolaryngologists as it is among general surgeons (likely) and to consider subjective and formal evaluations of EI in our selection process.