Effective leadership in the OR starts with emotional intelligence

Whether they realize it or not, all orthopaedic surgeons are placed in a position of leadership. Even if they do not hold a formal leadership title, their patients look to them for guidance, and they are responsible for leading their clinics and OR teams on a daily basis. Therefore, to maximize performance, happiness, and team morale, one must be an effective and inspiring leader.

What is the key to obtaining and maintaining these essential leadership skills? Research has found that the most critical element to becoming an effective leader is not intellect or technical skills but rather a high degree of emotional intelligence.

Demonstrating emotional intelligence can help surgeons navigate the social complexities of the workplace, lead and motivate others, and excel in their careers. Simply put, emotional intelligence measures how one interacts with others. It is a set of skills to recognize, understand, and manage one’s emotions and to recognize, understand, and influence the emotions of others.

How often have you found yourself flying off the handle at the OR staff when something goes wrong during surgery? Have you ever been rude or sarcastic with a nurse over the phone? Can you remember hastily firing off an angry email response only to regret it later?

These are all examples of behaviors demonstrating low emotional intelligence, which can result in workplace conflicts and misunderstandings.

Fortunately, your emotional intelligence can change. Like any set of skills, it can be learned, and it is learnable at any point in life. You can improve your emotional intelligence through deliberate practice. Why is it important to have high emotional intelligence? Those with high emotional intelligence are more likely to stay calm under pressure, resolve conflict effectively, and respond with empathy. These are all traits that are not only desirable but necessary for surgeons. It can also improve your mental health and allow you to build stronger relationships, leading to improved work performance.

Self-awareness
There are four key components of emotional intelligence. The first is self-awareness, which is foundational. All other components of emotional intelligence depend on this initial step.

Self-awareness is the ability to understand your own strengths and weaknesses, as well as identify your emotions and the impact you have on others.

An example of self-awareness would be recognizing when an automatic emotional response has been triggered (e.g., panic when something goes wrong in the OR) and anticipating the response before it happens. People who are truly self-aware tend to be more confident, communicate more effectively, and make better decisions.

However, measuring self-awareness can be difficult. Receiving honest, constructive feedback is key, and one of the best methods is a 360-degree emotional intelligence assessment. These assessments can be administered by certified coaches, consultants, or qualified human resources professionals. In this exercise, coworkers and colleagues provide feedback such as how a team member responds to a difficult situation, how adaptable they are, and how they handle conflict. This analysis requires a thick skin but offers an invaluable perspective into how one’s actions are perceived by others.

Self-management
Responses to stressful situations tend to be automatic and not always rational or appropriate. Emotionally intelligent leaders with self-awareness of reflex responses can manage their emotions and behaviors. The goal of self-management is to develop response flexibility — the ability to pause before action. The more one can widen the gap between impulse and action, the more emotionally intelligent they become.

People with strong self-management can pause and take a deep breath in tense and stressful situations, which allows them to remain calm and think before they speak or act. With self-management, effective leaders can restrain themselves from disruptive impulses to lash out at team members or send biting, acerbic emails until they have had a moment to clear their minds. They avoid letting upsetting emotions cloud their judgment.

For those who lack self-regulation, their own negative emotions and urges often set off a damaging chain reaction of negative emotions in others. For example, if a surgeon reacts in anger to a trigger during a procedure, OR staff may feel on edge or fear retribution and thus may hesitate to speak up. People who can manage their emotions and reactions effectively also tend to keep a positive outlook and demonstrate an adaptability to a variety of circumstances and situations.

Social awareness
Having social awareness means recognizing and interpreting the mainly nonverbal cues others are constantly using to communicate. In other words, effective leaders need to learn how to read the room. This is most effectively performed by showing care to others: Practice active listening, be present, and communicate in a language others can understand. Leaders who excel in social awareness practice empathy. Understanding colleagues’ feelings and perspectives enables better collaboration and helps build relationships that are necessary for a healthy and prosperous workplace.

Relationship management
Relationship management refers to the ability to influence and inspire others, as well as the capacity to smoothly resolve interpersonal conflicts. Although this may require having difficult conversations, it is important to confront conflict with team members rather than avoid it. Remaining calm and finding fair solutions will be respected by the team, and this ranks as one of the top factors in maintaining job satisfaction.

In summary, no matter how brilliant they are or how technically excellent their surgical skills are, orthopaedic surgeons who cannot effectively communicate or collaborate with others will not be successful.

For those who are interested in learning more about the concept of emotional intelligence, there are a number of online courses, self-help books, and podcasts on this topic. In addition, working with a surgical coach can provide a unique opportunity for self-improvement and personal growth by evaluating and addressing your emotional intelligence needs.

Christopher Iobst, MD, is the director of the Center for Limb Lengthening and Reconstruction at Nationwide Children’s Hospital in Columbus, Ohio.