Type at the Family Conference Table: In the Grip

27 May 2016

Written by Mathew David Pauley, JD, MA, MDR

This is the final post in my 10-part blog series, “Type at the Family Conference Table,” and I would like to begin by thanking CPP for a great collaboration throughout my participation in the MBTI® Certification Program and throughout these posts. Certification Trainer Michael Segovia and his team went out of their way to assist me during the program (which was sort of a birthday present), increasing the pressure for me to have the week go well!). I would also like to thank Associate Marketing Manager, Eugeniá Wright, for all of her assistance in putting together this blog series.

I came to learn about personality type in the course of my work in a very niche field in healthcare of clinical ethics consultation and have found it very useful. This blog series has focused thus far on individuals in the hospital who (1) are typically stressed out and often even traumatized, and (2) are called upon to make significantly important and impactful decisions for themselves and sometimes the people they love. This is the tragic nature of medical decision making. In an attempt now to expand my view, I want to close the series with a related look at the hospital itself.

In September 2015 I attended two very different conference sessions. The first was at the 2015 MBTI® Users Conference, where we looked at the MBTI type preferences of different business cultures. For example, technology and engineering tend to reflect an NT culture, with values and norms promoted by Intuitive Thinking types. Healthcare, on the other hand, is by and large an SF culture, valuing genuine communication, collaboration, and providing practical care to people. Obviously, aspects of all type preferences are present in a hospital, but looking at the mission statements and values posted on the walls, and the unifying fact that every person there is there to help people, the culture certainly skews toward Sensing and Feeling.

At another conference for healthcare leaders in California, an emergency room physician talked about “institutional trauma,” the concept that just as physical trauma can impact individuals, an institution like a hospital can suffer trauma throughout its systems too. Distrust among colleagues increases and communication decreases. The organization may become more risk averse and unwilling to meet the needs of some of its customers on the fringes. The narrative of the trauma can get repeated and repeated, lowering morale. For a hospital, or a unit within a hospital, it can be triggered by the unanticipated loss of a patient or even the loss of a colleague. A souring relationship between the medical team and a family can also send ripples across the unit.Busy Nurse's Station In Modern Hospital

I asked myself whether an institution can find itself experiencing something analogous to the significantly stressed individuals I encounter in my work. This is (more of a thought exercise than anything else). For example, hospitals are under continual pressure to be affordable; but they also require a financial margin that will allow them to keep their doors open in order to deliver care (the mantra “no margin, no mission” get thrown around a lot). Financial responsibility is an ethical obligation the hospital has to all patients seeking care from the hospital; objectively weighing pros and cons and focusing on the most good for the most people is typical of an NT preference. However, the good for the many will often come at the expense of the one.

The SF preference places much of the focus on the one. This is why healthcare is considered to have an institutional preference for Sensing and Feeling—when we are under doctors’ and nurses’ care, we want (and demand) that they focus on us as individuals before thinking about resources and financial margins. But again, the institution needs to focus on all its patients. It’s hard to think about, and it’s frustrating, but without fiscal responsibility suffering can increase for a population of individuals. The answer, of course, is that hospitals need to focus on both.

If hospitals indeed reflect an SF culture, they clearly need to flex if they are going to satisfy their NT obligations, such as when many hospitals endured the growing pains and systems struggles associated with moving from hand-written medical notes, to an electronic medical record.  The need to flex is a given, but it is draining and can trigger stress-induced eruptions akin to what their patients and families are experiencing inside their very walls, especially during traumatic events. At those times, even hospitals can act in ways that make them seem significantly different from the places of healing we strive to make them.

Want to read more? Check out my previous blogs in this series:


 

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