What is the Narcissistic Physician?
All of us since that first cry, that first breath of air coming out of our mother’s womb are then subjected to a learning experience of life. Of course there are genetic traits;however we cannot close our eyes to the effects of our environment. Parental role models, mentors good and bad, media, education, and peers. We develop morality, values and opinions. If we are open minded those opinions are in constant flux, and we are learning, and modifying our views. To keep the same views the same opinions for years is conforming, not becoming a separate individual with individual thought. We know that personality is developed by many factors, genetics, parents, media, stress, trauma and life experience in general. Physicians are no different. For this article I will use the term clinician which refers to physicians, chiropractors, physician assistants, nurse practioners and dentists. We cannot go through life and not be subjected to the impact of a narcissist at some point. Please review narcissistic personality disorder on Peace and Healing to obtain detailed information of this personality type.
Narcissism does not just exclusively target the health care field; however, it does seem to have it’s fair share of narcissistic personalties. There is much speculation on why this is; however, it is exactly that, speculation. Is it the years of schooling? The nature of saving lives? The sense of entitlement due to role of saving lives? The title itself? The perception of prestige? or The monetary gain as a goal which eludes to power? Most likely all of the above play a role. I have wondered, does this personality develop before medical school or after? Personality inventories done on medical students during their last year before their residency clearly indicate skewed values, and distorted perceptions of income.
It is the clinician that admits error, that calls a consult, that asks his colleagues questions that excels in patient care. This individual may not have the best bedside manner but you can be sure they are humble enough to understand they cannot know or learn all of the medical treatment interventions at a quality level. The owner of a clinic or clinics that micro-manages the staff is a classic case. The individual does not allow independent thinking, and is so self absorbed that they must have control over their environment as well as their perception of patient care. I once worked for a physician and owner of a clinic that would ask nursing to make his coffee, ask for his pencil to be sharpened ( he was thirty paces to the front desk where the sharpener was and would call the front desk asking for the receptionist to walk back and obtain the pencil for immediate sharpening) call and ask nurses to obtain a phone number of a near by eating establishment and other chauvinistic, demeaning narcissistic behaviors. Needless to say it was very painful observing your friends and co-workers being treated so harshly. Narcissism is displayed in a variety of settings, in a variety of behavior. When this occurs in the medical field it is extremely dangerous to patients, costly to companies, disruptive to the clinicians family life, and lawyers just sit back licking their monetary chops for a medical error.
Not disclosing medical error, and rationalizing away a medical error are two of the major fallouts of the narcissistic clinician. The current state of this countries financial woes, combined with patients wanting to litigate at a drop of a hat has caused many clinicians to over diagnose, order too many tests, and causes the narcissistic physician to “lie.” Narcissistic personalities or proficient at manipulating, lying,and consistently implementing unethical behavior and at times illegal behavior for the all important dollar. Patient care becomes the secondary and tertiary concern, and the more they get away with this behavior the more confident they become.
It is not just about greed. Ask any nurse, any emergency department staff about a self absorbed physician interaction. The stories are endless, because they have been hurt, wounded, embarrassed, or ridiculed by a self absorbed,”holier than thou” physician. This atmosphere is not conducive to learning and alienates others from a good team approach to medicine. This is a clinician that is fairly easy to identify. This is the clinician that spends minimal time with you in the office, or examining room, the one that minimizes, ignores or even uses humor to address your questions. This is the clinician that does not entertain your fear or your concerns. He or she is also the clinician who will give you a smile, shake your hand, and appear caring, however, the bottom line is getting you in and out and writing you a script. If you have a clinician like this, wave your good-byes and seek out another provider.
The narcissistic clinician is very much into their credentials. They may even talk about themselves when no question has been solicited. As a clinician I teach the students who have rotated with me three motto’s to live by. Number one, “We are not selling socks.” We are dealing with human beings, with real emotions, with all different incomes, different intelligence, but they all have one thing in common….feelings. Feelings of pain, sadness, happiness and joy. Number two, ” Treat your patients as if you would treat a family member.” The last, number three, “ Admit what you do not know and give your best effort to find out the answer.” If you do these three motto’s you cannot go wrong with your intentions.
Do not be intimidated by your clinician. When that occurs you will be hesitant to ask questions and you will not feel as if you can approach with honesty. One cannot have a relationship with a provider, expect good care and not be honest. Honesty will be received well by the non-narcissistic clinician and a good relationship can begin.
There are many personality types, and there are many reasons why these exist. I hope this helps a few understand that in any position there are those that may not have the patients best interest at heart. It is your job as a consumer to filter through those clinicians and find one you can not only get good heath care from, but enjoy the journey with also.
In peace and healing, Dan Williams