What Does it Take to be Good a Doctor?

According to the Texas Medical Association there are three personality traits and disorders common to physicians: narcissitic, obsessive-compulsive and antisocial. I think the main question here is whether these traits are endemic amongst medical pratitioners (i.e. the trait makes the physician who he or she is), or does it manifest itself in the individual as they are preparing to enter the medical profession. I believe the later is true. As a disclaimer I am in no way saying that all physicians exhibit these personality traits. I actually googled "what personality traits make a good physician" and this site came up.

"Three personality traits and disorders will be discussed in this module: narcissistic, obsessive-compulsive,and antisocial. These three are the most commonly found among physicians.

Personality disorders are pervasive chronic psychological disorders which can greatly affect a person's life. Having a personality disorder can negatively affect one's work, one's family, and one's social life.

Personality disorders exist on a continuum from mild (traits) to more severe (disorders) in terms of how pervasive and to what extent a person exhibits the features of a particular personality disorder. While most people live normal lives with mild personality traits, during times of increased stress or external pressures (work, family, a new relationship, etc.) the symptoms of the personality disorder may intensify and seriously interfere with emotional and physical functioning.

Those with a personality disorder possess several distinct psychological features including disturbances in self-image; inability to have successful interpersonal relationships; inappropriate range of emotion; misperceptions of themselves and the world; and difficulty possessing proper impulse control. These disturbances combine to create a pervasive pattern of behavior and inner experience that is quite different from the norms of the individual's culture and that often tend to be expressed in behaviors that appear more dramatic than what society considers usual. Consequently, those with a personality disorder often experience conflicts with other people and vice-versa.

Narcissistic Personality Disorder

• Has grandiose sense of self-importance
• Is preoccupied with fantasies of success, power, brilliance
• Believes self to be “special”
• Requires excessive admiration
• Has a sense of entitlement
• Is interpersonally exploitative
• Lacks empathy
• Shows arrogant, haughty behaviors

Narcissistic people try to sustain an image of perfection and personal invincibility for themselves, and attempt to project that impression to others as well. Those with Narcissistic Personality Disorder project an inflated sense of self because typically beneath that image of grandiosity is often an insecure person with very low self-esteem.

Narcissistic Personality Disorder tends to be more common in men than women. Because of their inflated sense of self-importance, narcissists tend to be driven to achieve high levels of accomplishments.

Obsessive-Compulsive Personality Disorder

• Preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency, as indicated by four or more of the following characteristics:
• Preoccupation with details and order
• Perfectionism that interferes with task completion
• Excessive devotion to work
• Rigidity and stubbornness
• Pack-rat (keeps evrything)
• Expectation of complete compliance
• Miserly (financial)

Obsessive-Compulsive Personality Disorder is not the same thing as Obsessive-Compulsive Disorder.
Individuals with Obsessive Compulsive Personality Disorder (OCPD) often are characterized by their lack of openness and flexibility in their daily routines as well as by problems with interpersonal relationships and expectations. An overwhelming preoccupation with orderliness, perfectionism and control of their lives and relationships makes treatment difficult.

Individuals with OCPD have difficulty incorporating new and changing information into their lives. Their ability to work with others is equally affected, since they see the world as black and white--their way of doing things and the wrong way of doing things.

Examples of OCPD would be checking and rechecking dosages; excessive work-ups, etc.

People with OCPD do not feel embarrassed or shameful because of their behavior, whereas people with OCD have a sense of shame. Behavior of the individual with OCPD affects everyone else, making them feel uncomfortable, while behavior of the individual with OCD affects primarily the individual and not everyone around him/her.

Antisocial Personality Disorder

A pattern of disregard for and violation of the rights of others, with three (or more) of the following traits:

• Repeated unlawful behavior
• Deceitfulness
• Impulsivity
• Irritability and aggressiveness
• Recklessness
• Consistent irresponsibility

The main features of Antisocial Personality Disorder (ASPD) revolve around a pervasive lack of remorse or lack of exhibiting any feelings at all. While it tends to be most common among those who run into trouble with the law, there are those individuals with a milder form. We may know him as the politician who feels comfortable lying continuously to the public or the neighbor who constantly cheats on his wife, gambles away the family money, or runs a shady business operation cheating others out of their money.

Examples of physicians with Antisocial Personality Disorder:

Insurance fraud

1. Medicare/Medicaid fraud
2. Over-prescribing
3. Over-utilizing for personal gain (ordering too many tests)
4. Sexual predators"