Brief Report: Physician Narcissism, Ego Threats, and Confidence in the Face of Uncertainty, 2010, Alexander et al.

SNT Gatchaman

SNT Gatchaman

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Brief Report: Physician Narcissism, Ego Threats, and Confidence in the Face of Uncertainty
G. Caleb Alexander; Jennifer Humensky; Cesar Guerrero; Hannah Park; George Loewenstein

Although adequate self-esteem is essential for psychological health, people with high but fragile self-esteem have been shown to exhibit defensive, often aggressive behavior when their self-esteem is threatened. We measured physician narcissism (as a proxy for high but fragile self-esteem) and used a subtle manipulation to examine how physicians who varied in levels of narcissism responded to an ego threat. We found that physicians high in narcissism, as compared with those lower in narcissism, were more likely to respond to ego threat by attempting to bolster their self-image. Concerned about self-image, physicians in this situation may be insufficiently receptive to new information and instead attempt to justify initial opinions.

Link | Paywall (Journal of Applied Social Psychology)
 
The medical profession attracts individuals who are confident, and this is an important characteristic of most physicians that helps them to reassure patients and to engage in work that is often characterized by considerable uncertainty and high stakes.
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In this study, we found support for the hypothesis that physicians with high but fragile self-esteem (as measured by their degree of narcissism) would respond to an ego threat by stating greater self-perceived invulnerability to conflicts of interest, relative to their peers.
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Our findings describe [...] the ways that subtle events that shake a physician’s confidence [...] may fail to be appropriately incorporated because of the threat that they may pose to a physician’s ego.
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Numerous clinical instances abound in which physicians must navigate uncertainty, such as [...]. In each case, physicians must manage potential threats to their own self-esteem and common pitfalls of clinical reasoning while serving the interests of their patients. Our findings raise the question of whether, in these settings, some physicians manage threats to their self-esteem by reacting with greater confidence than is appropriate, given the available clinical evidence.
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