Doctors are often accused of having a big ego

Why having a big ego can be a good thing

I was told I had a big ego. Ever been told you have a big ego? It's not usually a compliment. However, I suspect that all driven and reasonably successful people have a big ego, out of necessity. The big ego permits you to believe in what you are doing, to make split second decisions without self-doubt, to push the boundaries, to look over the horizon, to absolutely believe you are right.

However, in my line of work, a big ego is not an excuse for a lack of empathy, especially when it comes to dealing with patients. There's a world of difference between confidence and arrogance. The downside of having an ego is that toes get stepped on, people don't get the credit they deserve. Hardheadedness sometimes creates tone deafness to other ideas or flags of caution. The big ego is not always right.

But if you believe that most of what we know is not true, that if we're doing the same thing tomorrow as we're doing today, then we haven't learned anything, that everything we see and touch we can make better, that there is so much to do contribute to this world that sleep is mostly an interference, that the more you contribute the better you feel, that there is no end to learning and applying the lessons, then the big ego is a requirement.

So should we train people to have an ego? Is it even teachable? We tried in a subtle way with our kids. We told them that if every day they did four things — educate themselves, be a good person, contribute to the world and have fun — then they would be doing well. It actually takes an ego to do that every day. It can be a quiet, conservative, subtle, big ego or it could be a louder, gregarious ego. Either way, it takes the confidence to see what could be better and the guts to make it so.

More importantly, how do you recognize when the ego is a problem? Balancing an ego with humility and compassion is essential. Fortunately, if you have people you love around you or have wisely empowered your staff, colleagues, friends or teammates to interject, interview and speak up, then the misdirections can be nipped in the bud. That takes teamwork. And teamwork is the key to big egos becoming big successes.

A study led by a team at the Harvard School of Public Health is currently examining teamwork and communication in cardiac surgery operating rooms, and has found that the biggest egos only sometimes make the best surgeons, but the best communicators are always the best leaders. Great leaders are able to take good skills and make them shine nearly every time where poor leaders fail without backup support. But most interestingly, the study is demonstrating that interventions with the poor communicators lead to improvements, even at the extremely high ego level of top heart surgeons.

The lessons of teaching communication, teamwork and success are intertwined with teaching ego as a skillset in combination with teaching communication skills. In the past, silly statements by coaches in sports would be “There is no I in team.” They didn't get it. The “I” is the leadership by the big ego who understands the fact that teams need to be led and leadership is as much about communication as it is about action. The fact that my colleague called me on my ego made my day.

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