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Gold, incentives and meh

Does your personality fit?

GPs' personalities have a huge impact on their performance at work and getting the right mix of people is crucial to partnership success ­ Dr Jennifer King and Dr Jenny Firth-Cozens explain

GPs' personalities have a huge impact on their performance at work and getting the right mix of people is crucial to partnership success ­ Dr Jennifer King and Dr Jenny Firth-Cozens explain

Doctors' professional performance has become the focus of relentless scrutiny in recent years. There are many factors that influence this1, and personality type is a significant one. There are five personality traits that predict successful job performance in a wide variety of occupations2:

  • Conscientiousness ­ being hardworking, organised and self-disciplined
  • Emotional stability ­ being resilient and relaxed under pressure
  • Openness ­ being creative, open to change and learning, intellectually curious
  • Extroversion ­ being outgoing
  • Agreeableness ­ being co-operative.

Personality type

Type, as outlined by the Myers Briggs Type Indicator (MBTI)3, is the most used psychological test in organisations worldwide. It is based on the idea that an individual has characteristics and preferences that make up one of 16 types.

Type clearly has major implications for behaviour and performance in medicine, particularly in how a team functions4. For example, extroverts derive energy from people and may talk first and think later. Introverts are more reflective but may not always express their ideas openly. Sensing types focus on detail and the present, perhaps becoming too absorbed with, say, a test result rather than focusing on the bigger picture as intuitives would do. But intuitives may miss or ignore important details.

Thinkers prefer logical analysis and may seem blunt or critical to feelers, who prefer harmony to conflict and want to ensure people's needs are looked after. Finally, judging types like plans, structure and reaching a conclusion, whereas perceiving types are easily distracted and may be casual about deadlines. They are more likely to overrun in surgery, for example, but may be seen as more flexible by their patients.

While people do not change their type they can learn to use their preferences to best effect and to appreciate the benefits of other types.For a patient, having a doctor who is a perfectionist sounds like good news. But taken to its extreme, the doctor may slip into obsessional-compulsive behaviour patterns, checking and rechecking signs and symptoms, for example, and finding it difficult to make decisions. Self-criticism and self-esteem can affect a doctor's performance.

High self-criticism is related to depression in doctors and predictive of the condition over many years. Those who are very self-critical judge themselves harshly but also have a fear of being disapproved of and criticised. Without supportive colleagues, this is a difficult characteristic for doctors4. On the other hand, having unwavering faith in one's abilities is clearly not ideal. In studies outside medicine, very high self-esteem has been linked to aggression4 and, similarly, doctors with particularly low self-criticism have been found to have more problems with colleagues and patients4. Most doctors are caring, conscientious, detail-conscious, independent and robust. But under pressure people can overplay their strengths ­ especially if they are not very resilient to stress5.

Then confidence becomes arrogance, diligence turns into perfectionism, caution into indecisiveness and independence becomes withdrawal and resistance to feedback. These behaviours typically emerge at times of transition, fatigue, anxiety or other stressful situations.Just because a doctor has been successful in one setting does not mean the same skills can be transferred to another one, especially if the new context is more complex or stressful. Support and training are crucial.

Personality itself is difficult to change. Behaviour, on the other hand, can. Success depends on several factors including insight, self-control, conscientiousness, self-confidence and openness to learning and change.

Attributes such as empathy ­ part of what is now known as emotional intelligence ­ are now recognised in the RCGP Good Medical Practice for GPs6, while teamworking, leadership and communication are part of the new core curriculum.

When selecting doctors at every level and guiding them in their career choices, it will be increasingly essential to look for these characteristics.

Jenny Firth-Cozens is a clinical and occupational psychologist

Adapted from a chapter by Dr Jenny Firth-Cozens and Dr Jennifer King in Understanding Doctors' Performance, Radcliffe Publishing 2005(1)

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