Journal of Psychology & Clinical Psychiatry Understanding the Psychology behind Physician Attitudes, Behaviors, and Engagement as the Pathway to Physician Well- Being Submit Manuscript | http://medcraveonline.com Volume 5 Issue 6 - 2016 Practicing Internist in San Francisco California, Health care consultant, USA *Corresponding author: Alan H Rosenstein, Practicing Internist in San Francisco California, Health care consultant, 139 15 th Avenue, San Francisco, CA 94118, USA, Tel: 4153707754; Email: Received: May 05, 2016 | Published: May 10, 2016 Commentary J Psychol Clin Psychiatry 2016, 5(6): 00312 toward patient care. This is a serious situation. Physicians are a precious resource. In order to keep them going we need to gain a better understanding of the factors influencing their thoughts and emotions and provide the necessary resources to help them better adjust to the pressures of today’s health environment. Behavioral Influences In order to change perceptions and behaviors we need to gain a better understanding of the factors contributing to ones disposition. Table 1 provides a list of internal and external factors that can influence individual values, perceptions, biases, attitudes, and behaviors that can impact personal and work relationships. Table 1: Influencing Factors. Internal Factors External Factors Age and generation Training Gender Health Care Reform Culture/ethnicity/ religion Work environment Geography/ life experiences Personal issues/ life events Personality Stress and burnout Age and generational issues are based on values and reactions reinforced by the current affairs of the environment in which the individual grew up. Differences in views as to work ethic, commitment, views of authority, and work life- balance are different for each of the groups (Millenniums, Generation X, Baby Boomers, Veterans) which under stressful situations may lead to conflict in the workplace environment. Gender differences may also affect the way individuals react in stressful situations. Males are typically more assertive, task oriented, and domineering, and under pressure tend to dig in. Woman are more socially oriented and under pressure will look for consensus opinions to support their points. Ethnic, cultural, and religious beliefs may present with different views on spirituality, hierarchy, power, and communication styles that can lead to misunderstandings that can be accentuated in stressful situations. All of these factors combined with genetics, geographic mannerisms, and other life experiences help to shape an individual’s personality. These internal factors have a deep seated impact on a person’s character and disposition and may be more difficult to address than some of the external factors to be discussed in the next section. Strategies for improvement should focus on introducing a variety of different training programs designed to enhance personality and relationship management. These programs might include such topics as sensitivity training, diversity management, cultural competency, mindfulness, generational gap values, personality traits, conflict management, stress management, anger management, sexual harassment training, customer satisfaction, and improving overall communication and collaboration skills. In a recent article in this Journal I highlighted the value of providing special training in the area of Emotional Intelligence [2]. Each of these programs have value, but success will depend on the specific situation, underlying organizational dynamics, culture, and leadership commitment. The external factors include current day circumstances that influence present state perceptions. For physicians one of the key factors is the training environment. Some equate this with a fraternity/ sorority hazing type environment where individuals are harassed to the point of losing self- esteem. In response the trainees try to develop knowledge and technical competencies through exhaustive independent study. As a consequence there is no focus on developing personal skills or team collaboration mechanics which leads to a lower degree of sensitivity and emotional intelligence which is a definite liability in today’s complex multi-spectrum health care environment. The problem is further exacerbated by the traditional hierarchal health Commentary Physicians just want to practice good medicine. In 2008 the renowned author Malcom Gladwell presented a talk at a national medical conference titled “The duality of being a doctor” [1]. In his presentation he highlighted the productive personal side of being a physician rewarded by a mission driven spirit, dedication and commitment, and the idealism of helping people get better. He then discussed the growing conflicts generated by the impersonal side of health care business economics which negatively affects physician attitudes and threatens the future of medicine. How right he was. Over the past several years physicians have become increasingly frustrated with the practice of medicine and it has negatively impacted their attitudes and behaviors