Skip to main content
The Keckley Report

The Food Fights in Healthcare test our “Emotional IQ”

By May 9, 2016March 1st, 2023No Comments

Emotional intelligence (EQ) is not a new idea. In corporate America, it’s widely recognized as an essential quality for effective leadership. Sadly, healthcare may be lagging other industries in addressing EQ for its leaders and caregivers.


Much has been written about EQ in social sciences and business research. Daniel Goleman defined EQ as “the capacity of individuals to recognize their own, and other people’s emotions, to discriminate between different feelings and label them appropriately, and to use emotional information to guide thinking and behavior.” Patricia Harmon described it as “the ability to harness your emotions in sensing, understanding, and responding adeptly to social cues in your environment.” And psychologists John Mayer and Peter Salovey wrote “emotional intelligence is the ability to accurately perceive your own and others’ emotions; to understand the signals that emotions send about relationships; and to manage your own and others’ emotions. It doesn’t necessarily include the qualities (like optimism, initiative, and self-confidence) that some popular definitions ascribe to it.” It’s essentially the capability of an individual to sense the feelings of those in their surroundings and respond appropriately. And it’s a big deal for companies and organizations these days.


The origins of EQ date to the 1930’s when the concept of “social intelligence” was applied to organizational performance. Through the years, management guru’s, social scientists and academicians studied the correlation between emotional intelligence in the C suite and an organization’s overall performance. What resulted is a certain relationship between a leader’s EQ and how a company or organization behaved—its performance in the marketplace.

Goleman, a Rutgers University psychologist, identified 5 key domains of EQ: self-awareness, self-regulation, self-motivation, empathy and social skills. He concluded: “truly effective leaders are distinguished by a high degree of emotional intelligence. Without it, a person can have first-class training, an incisive mind, and an endless supply of good ideas, but he still won’t be a great leader.”  Others have proposed schemes for measuring EQ in an organization and metrics for assessing EQ in the C suite.

Boards are keen to recruit CEOs with high EQ and especially sensitive to criticism they overlooked EQ in a selection that ultimately led to a company’s downfall or underperformance. A Forbes analysis concluded “organizations today do promote the emotionally inept … except when they don’t. “ 

So, emotional intelligence (EQ) is a big deal in the marketplace, especially for boards who have responsibility for C suite activities and recruiters who are on the watch for the next CEOs.

EQ in healthcare

EQ is arguably more important to healthcare than any other industry.  Like other industries, we face challenges in addressing the solvency and sustainability of our organizations against new forms of competition and changing customer expectations. But our industry is unique in one respect: our end users—patients—depend on our performance with dire consequences when we fail.

The transition from volume to value a la the Affordable Care Act, increased pressures to reduce costs and widespread transparency about our shortcomings in social media and public report cards put a premium on EQ in our C suites. As things heat up, tensions mount. Food fights break out. That’s when EQ matters most. 

The Three Sets of Food Fights in Healthcare where EQ is Key

1-Internal food fights: In every organization, there are internal food fights among workers and workgroups as performance expectations change. In hospitals and post-acute settings, employees are expected to do more with less while adapting to new incentives and new risks. Physicians are insecure, demanding income security while resisting required changes like team-based care delivery, electronic health records and accountable care. In health insurance, internal food fights frequently center around decisions about plan design pitting actuaries and bean-counters against account teams who warn sensitive to customer backlash and negative publicity. In drug companies, drug pricing to enhance short term profits is a hot spot for food fights.  And in the consulting, legal and accounting professions that play key roles in our healthcare industry, food fights invariably center around revenue growth which takes precedent over any other criterion for advancement.

The emotional EQ of leaders in managing internal food fights is widely scrutinized in every organization: everyone watches and everyone knows. It’s the stuff of hallway banter and exit interviews.

2-External food fights: These are the extramural conflicts in markets where competition and growth are key dynamics. They’re classic in healthcare: insurers vs insurers for market share and differentiation, insurers & hospitals vs drug companies to fight drug price gouging, hospitals vs insurers for control of patient care and equitable payments, physicians vs retail giants interloping in direct medical care, state regulators vs. Medicaid MCOs seeking greater transparency and accountability, and so on. External food fights expose differences between organizational cultures and the EQ of its leadership. In healthcare, the EQ of our C Suites is being tested as consolidation accelerates, regulators prowl for lapses in compliance and media scrutinize performance—the good and the bad. And poor EQ makes great headlines when associated with an organization’s performance lapses—that’s a key rationale for non- disparagement clauses in separation agreements. It’s former executives in our organizations who know best the strength and character of the organization’s C suite, and the EQ of its leaders.

3-Patient Care Food Fights: And the most important application of EQ in healthcare, and what makes our industry unique, is in caregiving. Research shows effective EQ by a caregiver results in better outcomes, higher patient adherence and lower costs. But our food fights in patient care don’t get resolved until it’s too late: patients rarely challenge the lack of EQ of their caregivers, and care team members are hesitant to challenge physicians lacking EQ. Consumers say EQ matters more in healthcare than any other industry, but they believe it’s missing in their interactions with their doctors and caregivers. They sense our lack of empathy and caring and don’t regard efficiency pressures as justification for poor EQ. It’s our EQ gap in diagnosing, treating and managing patient care that may be most harmful in our system. 

For healthcare leaders in every sector and our caregivers who treat patients daily, our EQ is being tested. Let’s face it: the food fights are getting testier and they’re no fun.

For boards, getting and keeping leaders with high EQ is imperative: rewarding bullies who can sense no feelings other than their own is harmful to the company’s culture and bottom line. They rarely win food fights. 

Emotional intelligence (EQ) in healthcare deserves more attention in how we choose our leaders, how we train our caregivers, and how we handle our food fights.


Daniel Goleman “What makes a leader?” Harvard Business Review 1998 issue reprinted in Best of HBR Emotionally Intelligent Leadership, 2nd Edition. Harvard Business School Publishing Corp. 2008.

Patricia Harmon “Emotional Intelligence: An Edge for Leaders” Seminar, Cornell University ILR School 2016; Consortium for Research on Emotional Intelligence in Organizations

Daniel Goleman “What makes a leader?” Harvard Business Review January 2004 Issue, Reprint: R0401H