Is narcissism a good trait for a doctor?

[JBOB]

This topic sort of came up during an interview recently, and I saw an episode of scrubs which got me thinking about it. I feel like a person has to be at least a little narcissistic to want to become a physician in the first place. I mean, I think we all know that it's best for everybody if the people making life altering decisions on the fly, as many physicians do, are some of the smartest and most gifted in our society. To want to become a doc, you have to think that you are (or can be) one of those people. But then again... humility is obviously a good thing. I'm torn. Thoughts?

---

Members don't see this ad.

 

[911 Turbo]

no

 

[Spinach Dip]

Oh God no.

 

[red doctober]

...But House is a great doctor, right?

 

[Spinach Dip]

What we need are physicians who are aware of what they are capable of and what they aren't.

I'd say calmness, perhaps even a touch of cockiness can be useful when dealing with a case that a physician is experienced in (ie, I've done 100 prostate reductions, so I know what to do here...). However, they need to be capable of setting that aside and admitting that there are things they don't know or situations they have never experienced.



FYI, the word "narcissism" comes from the Greek story of Narcissus, who became obsessed with his own reflection. Today it means a love or exultation of ones self. And if I ever meet a surgeon like that, I will make sure he NEVER operates on me.

 

[JBOB]

What makes you so sure? It seems like most people who are exceptional at what they do have narcissistic tendencies. In medicine, everyone has to be at an exceptional level of competence, relative to the average Joe, anyway.

 

[MaenadsDance]

Words have meaning.

Narcissistic personality disorder is a condition in which people have an excessive sense of self-importance, an extreme preoccupation with themselves, and lack of empathy for others.

...

A person with narcissistic personality disorder may:

React to criticism with rage, shame, or humiliation

Take advantage of other people to achieve his or her own goals

Have excessive feelings of self-importance

Exaggerate achievements and talents

Be preoccupied with fantasies of success, power, beauty, intelligence, or ideal love

Have unreasonable expectations of favorable treatment

Need constant attention and admiration

Disregard the feelings of others, and have little ability to feel empathy

Have obsessive self-interest

Pursue mainly selfish goals

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001930/

Sound like someone you want for a physician?

Try substituting in "confident and self-assured" for narcissistic.

 

[kindasorta]

You have a very inflated and romantic notion of what doctor's do and what they know and what actually makes it challenging. The fact that you think it is these things you describe, and thus is appealing to you, pretty much tells me you're a narcissist.

But it doesn't matter. Medicine is hard because it's a lot of work, not because it's the work of genius or bravery or grand decision. It attracts a lot of people who are narcissists though, because those outside of medicine are too naive to realize medicine is nothing of the stuff of heroics or poetry. So people that think they're special and want to be admired disproportionately choose the field.

You won't be alone.

 

[JBOB]

Words have meaning.
synonyms: egotism, self-centeredness, boastful, ect


http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001930/

Sound like someone you want for a physician?

Try substituting in "confident and self-assured" for narcissistic.

I'm not talking about narcissistic personality disorder, I mean something more like this definition: " admiration of one's own physical or mental attributes". Sorry for the confusion, I should have specified.

synonyms: egotism, self-centeredness, boastful, ect

 

[JBOB]

You have a very inflated and romantic notion of what doctor's do and what they know and what actually makes it challenging. The fact that you think it is these things you describe, and thus is appealing to you, pretty much tells me you're a narcissist.

But it doesn't matter. Medicine is hard because it's a lot of work, not because it's the work of genius or bravery or grand decision. It attracts a lot of people who are narcissists though, because those outside of medicine are too naive to realize medicine is nothing of the stuff of heroics or poetry. So people that think they're special and want to be admired disproportionately choose the field.

You won't be alone.

I'm not making a point either way... I'm bringing up the question. In fact, the reason it came up during an interview is because I am a modest and sometimes self-conscious person. The interviewer made the point that the opposite is sometimes needed in medicine.

 

[kindasorta]

I'm not making a point either way... I'm bringing up the question. In fact, the reason it came up during an interview is because I am a modest and sometimes self-conscious person. The interviewer made the point that the opposite is sometimes needed in medicine.

My guess is your self-consciousness is why you're choosing a field with all those superlatives you've attached to it (keep in mind, those descriptions of medicine are YOURS - you chose those words to describe the work of a doctor). You think it'll demonstrate not only to yourself, but most importantly to everyone you meet, how awesome you are.

I'm not calling you out. I just see it again and again and again. It's the standard character description of 90% of medical students and eventual physicians.

 

[JBOB]

My guess is your self-consciousness is why you're choosing a field with all those superlatives you've attached to it (keep in mind, those descriptions of medicine are YOURS - you chose those words to describe the work of a doctor). You think it'll demonstrate not only to yourself, but most importantly to everyone you meet, how awesome you are.

I'm not calling you out. I just see it again and again and again. It's the standard character description of 90% of medical students and eventual physicians.

Hmmm. I feel like you are making a pretty darn big assumption about my interest in medicine based on the tiny amount of information I have given in this thread, not to mention my reasons for being humble/self onscious at times However, I made this thread because I'm interested in what the medical community thinks of this issue. I'm curious, are you a med student/resident/attending?

 

[kindasorta]

Hmmm. I feel like you are making a pretty darn big assumption about my interest in medicine based on the tiny amount of information I have given in this thread, not to mention my reasons for being humble/self onscious at times However, I made this thread because I'm interested in what the medical community thinks of this issue. I'm curious, are you a med student/resident/attending?

Medical student and I told you what I think of the issue. "life altering decisions on the fly, smartest/most gifted in our society" These are your descriptions, are they not?

 

[JBOB]

Medical student and I told you what I think of the issue. "life altering decisions on the fly, smartest/most gifted in our society" These are your descriptions, are they not?

I used those descriptions because I was interested to know if others felt they were accurate. I have heard physicians described that way and I'm unsure of my opinion, that's why I'm asking about it in this thread. Do you not think physicians need to be exceptionally smart? They do make life altering decisions on the fly... at least some do, on occasion. Is that incorrect?

 

[MaenadsDance]

The narcissist is defined not by their self-confidence but by their extreme anxiety that anyone will destroy the self-image they create for themselves. The egotism is a reaction to the fear that someone will realize that the narcissist is not as intelligent, brave, beautiful, famous etc as they claim and wish to believe.

If you're going into medicine because you're insecure but you've heard that physicians are admired for their bravery, intelligence, judgment, quick decision-making abilities... welllll....

 

[kindasorta]

I used those descriptions because I was interested to know if others felt they were accurate. I have heard physicians described that way and I'm unsure of my opinion, that's why I'm asking about it in this thread. Do you not think physicians need to be exceptionally smart? They do make life altering decisions on the fly... at least some do, on occasion. Is that incorrect?

To think of medicine as "making life altering decisions on the fly" betrays a complete naivete to the realities of medicine. The large majority of doctors aren't involved in acute life threatening issues, and those that are aren't reiventing the wheel with each new patient.

No I don't think physicians need to be exceptionally smart at all (minus the intellectual screening done to get through the process). The actual job itself falls very low on the list of jobs with intellectual rigor.

 

[DrNoo]

good for surgeons.

 

[JBOB]

The narcissist is defined not by their self-confidence but by their extreme anxiety that anyone will destroy the self-image they create for themselves. The egotism is a reaction to the fear that someone will realize that the narcissist is not as intelligent, brave, beautiful, famous etc as they claim and wish to believe.

If you're going into medicine because you're insecure but you've heard that physicians are admired for their bravery, intelligence, judgment, quick decision-making abilities... welllll....

I just gave you the definition of of narcissism that I'm referring to (egocentric, overly confident, ect), so I really don't understand what you're getting at. When did I say I was going into medicine because I was insecure? That was entirely not the point.

 

[JBOB]

To think of medicine as "making life altering decisions on the fly" betrays a complete naivete to the realities of medicine. The large majority of doctors aren't involved in acute life threatening issues, and those that are aren't reiventing the wheel with each new patient.

No I don't think physicians need to be exceptionally smart at all (minus the intellectual screening done to get through the process). The actual job itself falls very low on the list of jobs with intellectual rigor.

The overall majority of physicians don't make life altering decisions on a regular basis, I agree. But shouldn't most be capable of it? I, for one, would not feel comfortable going under the knife if the surgeon mentioned to me that he wasn't capable of making life altering decisions quickly. Things can and do go wrong, physicians need to be able to know what to do when that happens.

 

[kindasorta]

The overall majority of physicians don't make life altering decisions on a regular basis, I agree. But shouldn't most be capable of it? I, for one, would not feel comfortable going under the knife if the surgeon mentioned to me that he wasn't capable of making life altering decisions quickly. Things can and do go wrong, physicians need to be able to know what to do when that happens.

They do know what to do and it isn't rocket science. There's only so much you can do (uh, stop the bleeding), and I guarantee your FM doctor looking at your toes, or your radiologist looking at a computer, or an IM doctor asking if you crapped last night don't deal with that. The surgeons that do deal with, deal with that. It's not someone parting of the skies moment, it's pretty mindless actually.

 

[darklabel]

You do know life altering decisions that you make on the fly are taught to you, right? Not like you came up with it.

I don't think physicians should be narcissistic. Your job shouldn't be all that describes you, rather it should just be what you do to make a living/help society.

I have respect for doctors, but scientists(especially Nobel prize winners), military officials and such deserve as much praise, if not more.

 

[JBOB]

They do know what to do and it isn't rocket science. There's only so much you can do (uh, stop the bleeding), and I guarantee your FM doctor looking at your toes, or your radiologist looking at a computer, or an IM doctor asking if you crapped last night don't deal with that. The surgeons that do deal with, deal with that. It's not someone parting of the skies moment, it's pretty mindless actually.

Aren't you oversimplifying just a little bit? Okay... let's assume that one in a thousand cases/operations is complicated and requires a somewhat sophisticated skill-set and competence level (this is by far an underestimate, considering the rate of medical and surgical errors in some particularly difficult specialties), and let's assume that a physician sees as many as ten thousand cases in his/her career. Even if this is the case, wouldn't the lives of ten people be negatively affected in a big way if physicians aren't smart enough to handle them? If a person of average skill could handle 5 of the 10 correctly, and a person of exceptional skill could handle 7 of the 10 correctly, wouldn't it be best if all physicians were at an exceptional skill level?

 

[kindasorta]

Aren't you oversimplifying just a little bit? Okay... let's assume that one in a thousand cases/operations is complicated and requires a somewhat sophisticated skill-set and competence level (this is by far an underestimate, considering the rate of medical and surgical errors in some particularly difficult specialties), and let's assume that a physician sees as many as ten thousand cases in his/her career. Even if this is the case, wouldn't the lives of ten people be negatively affected in a big way if physicians aren't smart enough to handle them? If a person of average skill could handle 5 of the 10 correctly, and a person of exceptional skill could handle 7 of the 10 correctly, wouldn't it be best if all physicians were at an exceptional skill level?

You're arguing from a perspective that is born from watching too many movies. That's just not how medicine works.

And you keep using this word "smart". You're in for a rude awakening if you think it's intelligence that keeps an OR moving.

 

[JBOB]

You're arguing from a perspective that is born from watching too many movies. That's just not how medicine works.

And you keep using this word "smart". You're in for a rude awakening if you think it's intelligence that keeps an OR moving.

Replace the word "smart" with gifted, talented, whatever floats your boat, it doesn't change the law of big numbers. If only one patient at one moment in the entire career of a physician required a high level of skill for a positive outcome (this does happen, and it is sometimes a life or death scenario), I just don't see why it wouldn't be worth it for that doctor to have a high level of skill. I'll admit I'm playing the devil's advocate a little, but I'm pretty sure you're doing the same thing.

 

[kindasorta]

Replace the word with "smart" with gifted, talented, whatever floats your boat, it doesn't change the law of big numbers. If only one patient at one moment in the entire career of a physician required a high level of skill for a positive outcome (this does happen, and it is sometimes a life or death scenario), I just don't see why it wouldn't be worth it for that doctor to have a high level of skill. I'll admit I'm playing the devil's advocate a little, but I'm pretty sure you're doing the same thing.

It's not smart OR gifted OR talented. It's the product of years of situational repetition. The surgeon handling some weird rare case is not going to be your average local surgeon. It'll be the guy at the academic center that deals only in that weird rare case, so he too is a product of repetition. It's not because he's smarter or more gifted - it's because at his job, that's the case he studies. With certain exceptions, surgery does not even require physical talent. It's just hours spent in an OR. That's why it's hilarious to read every pre-med on here wanting to be a brain surgeon or whatever. It's ego. It's narcissism. Once going through medical school they realize it's not some romantic thing, it's not at all what they thought it was, and they run for the hills into a specialty which affords a life. That's intelligence.

 

[WhizoMD]

I'm actually of the opinion that narcissism is a dangerous trait in a doctor. One very important aspect of the job is knowing your limits. Venturing beyond your scope of practice, because you feel confident in doing so, can lead to substandard care for your patients and animosity from your colleagues in other specialties.

 

[JBOB]

It's not smart OR gifted OR talented. It's the product of years of situational repetition. The surgeon handling some weird rare case is not going to be your average local surgeon. It'll be the guy at the academic center that deals only in that weird rare case, so he too is a product of repetition. It's not because he's smarter or more gifted - it's because at his job, that's the case he studies. With certain exceptions, surgery does not even require physical talent. It's just hours spent in an OR. That's why it's hilarious to read every pre-med on here wanting to be a brain surgeon or whatever. It's ego. It's narcissism. Once going through medical school they realize it's not some romantic thing, it's not at all what they thought it was, and they run for the hills into a specialty which affords a life. That's intelligence.

Well, okay. I see your point and, as I said, I'm not advocating a particular side of this argument. That's why I was asking about it, I want to know others opinions, especially those with more medical education than I have. With that said, I have to ask, do you honestly think being a good doctor, let's say... a trauma surgeon, doesn't require an exceptional level of talent? Just getting into medical school, I know, requires a significant amount of academic ability, or at least a work ethic far above the average.

 

[kindasorta]

Well, okay. I see your point and, as I said, I'm not advocating a particular side of this argument. That's why I was asking about it, I want to know others opinions, especially those with more medical education than I have. With that said, I have to ask, do you honestly think being a good doctor, let's say... a trauma surgeon, doesn't require an exceptional level of talent? Just getting into medical school, I know, requires a significant amount of academic ability, or at least a work ethic far above the average.

Perfect example. You think trauma surgeon is some wild thing. Trauma surgeons spend more time rounding on inpatients than doing surgery. And the surgery they DO do is always the same stupid stuff. Anything beyond that bullet wound to the belly goes to the specialist on call that deals in that body part.

The biggest trait a surgeon has that places them above the rest of society is work ethic. A Type A personality. They are more willing to spend a large portion of their life in an operating room. And like I said before, that's usually a tree born from a seed of narcissism and self-esteem issues. They get into med school because they want to show the world how smart they are. They study hard in med school so they can be a surgeon to show their classmates how smart they are. They push through a miserable residency so they can graduate and tell everyone at cocktail parties they're a surgeon, and everyone will think how smart they must be. It goes on an on.

Intelligence only gets you into medical school. From day 1 of med school forward, it is 100% about how hard you want to work, not how big your brain is. In fact I literally think I've gotten stupider as a result of medical school and I'm not even joking.

 

[JBOB]

Perfect example. You think trauma surgeon is some wild thing. Trauma surgeons spend more time rounding on inpatients than doing surgery. And the surgery they DO do is always the same stupid stuff. Anything beyond that bullet wound to the belly goes to the specialist on call that deals in that body part.

The biggest trait a surgeon has that places them above the rest of society is work ethic. A Type A personality. They are more willing to spend a large portion of their life in an operating room. And like I said before, that's usually a tree born from a seed of narcissism and self-esteem issues. They get into med school because they want to show the world how smart they are. They study hard in med school so they can be a surgeon to show their classmates how smart they are. They push through a miserable residency so they can graduate and tell everyone at cocktail parties they're a surgeon, and everyone will think how smart they must be. It goes on an on.

Intelligence only gets you into medical school. From day 1 of med school forward, it is 100% about how hard you want to work, not how big your brain is. In fact I literally think I've gotten stupider as a result of medical school and I'm not even joking.

You think medical school has made you stupider? I certainly hope that isn't true... I would make some pretty big changes right about now if I believed that. But either way, I think you're missing my point a little. I'm not concerned with the 99% of the time that trauma surgeons spend doing mindless things or calling specialists for help. I'm talking about the 1% of time when their level of skill is important-when time sensitive, life altering, and difficult decisions are made. Or... getting away from surgery, the one correct diagnosis out of a hundred that a skilled IM doc correctly makes which a less skilled doctor would have missed.

 

[kindasorta]

You think medical school has made you stupider? I certainly hope that isn't true... I would make some pretty big changes right about now if I believed that. But either way, I think you're missing my point a little. I'm not concerned with the 99% of the time that trauma surgeons spend doing mindless things or calling specialists for help. I'm talking about the 1% of time when their level of skill is important-when time sensitive, life altering, and difficult decisions are made. Or... getting away from surgery, the one correct diagnosis out of a hundred that a skilled IM doc correctly makes which a less skilled doctor would have missed.

My closing thesis to you is that medicine is not a creative pursuit. It's a product of algorithms and repetition. You're painting a picture of some House-esque moment, and it just isn't realistic. You'll see the same problems, day in and day out, operate on the same problems day in and day out. And it becomes a job. Not a job that demands a huge brain. More than anything, it's a job that requires a huge amount of endurance, because it grates away at you.

BTW, most of the problems surgeons run into aren't because they're faced with some "life-altering decision" that requires some novel approach (that doesn't happen for 99% of surgeons), it's because they were in a hurry to get the hell out of the hospital and go home, and they f-upped an anastamosis, or left their Blackberry in the pt's abdomen.

 

[JBOB]

My closing thesis to you is that medicine is not a creative pursuit. It's a product of algorithms and repetition. You're painting a picture of some House-esque moment, and it just isn't realistic. You'll see the same problems, day in and day out, operate on the same problems day in and day out. And it becomes a job. Not a job that demands a huge brain. More than anything, it's a job that requires a huge amount of endurance, because it grates away at you.

BTW, most of the problems surgeons run into aren't because they're faced with some "life-altering decision" that requires some novel approach (that doesn't happen for 99% of surgeons), it's because they were in a hurry to get the hell out of the hospital and go home, and they f-upped an anastamosis, or left their Blackberry in the pt's abdomen.

I appreciate your opinion, and I hope you've had a good v-day, despite being a med student. The only thing I want to add is that there is a differential success rate amongst physicians. Yes the statistics regarding this are skewed due to confounding variables and yes some of the variation is due to random chance, but some of it isn't. Physicians all do the same job, but some do it better than others. Even if that just means being correct 99% of the time vs 99.9% of the time, it matters. This is the situation for many many careers, but medicine is one of the few where that extra little bit of skill can mean life or death for that one, rare patient.

 

[kindasorta]

I appreciate your opinion, and I hope you've had a good v-day, despite being a med student. The only thing I want to add is that there is a differential success rate amongst physicians. Yes the statistics regarding this are skewed due to confounding variables and yes some of the variation is due to random chance, but some of it isn't. Physicians all do the same job, but some do it better than others. Even if that just means being correct 99% of the time vs 99.9% of the time, it matters. This is the situation for many many careers, but medicine is one of the few where that extra little bit of skill can mean life or death for that one, rare patient.

It's not skill or brains that is separating these people, it's diligence. Medicine is very draining and tiring. Some fight off the instinct to phone it in better than others. That's the difference.

 

[JBOB]

It's not skill or brains that is separating these people, it's diligence. Medicine is very draining and tiring. Some fight off the instinct to phone it in better than others. That's the difference.

Agreed. But some of it has also gotta be due to making good judgement calls, there's just no way around it.

 

[kindasorta]

Agreed. But some of it has also gotta be due to making good judgement calls, there's just no way around it.

Arguing what 1% of medicine entails is a strange position to take when it will have little to no relevance to your career. A simple thought experiment will show you that medicine isn't what you seem to think it is: how many doctors are there? A lot. They all vary in inherent intellect. Isn't is strange that doctors aren't being (legitimately) sued left and right because some are dumber than others? The reason they aren't is because medical thinking is very structured. You seem to think it's like writing a symphony, and only the most rarified minds can truly compose a thing of timeless depth and beauty, while the average doctors are pumping out Gangham Style. In reality medicine is like baking a cake. The most brilliant doctor and your average doctor are still going to hand you a Red Velvet that tastes the same. The worst doctor forgot to put eggs in and f'd it up, not because putting eggs in is some gargantuan feat of intellect, but because he had to get to his kid's soccer game and is sick of making stupid cakes.

 

[Narmerguy]

I'm actually of the opinion that narcissism is a dangerous trait in a doctor. One very important aspect of the job is knowing your limits. Venturing beyond your scope of practice, because you feel confident in doing so, can lead to substandard care for your patients and animosity from your colleagues in other specialties.

Agreed. Narcissism means that to some degree, you are going to make decisions not because it is what's best but because it's what makes you feel/look best. That's never beneficial for patients. Being confident is beneficial, and I think doctors should be confident, but that this confidence should be tempered with realism and a devotion to patient care first and foremost--no amount of self-loving narcissism improves upon this.

Agreed. But some of it has also gotta be due to making good judgement calls, there's just no way around it.

Sure it does, but that doesn't mean one must be narcissistic to do that. Merely confident is enough. At no point is there a benefit to being narcissistic over confident.