Ever had that moment when you feel that somebody is wired completely differently to you?
The range of personalities you’ll work with in a healthcare team will be varied and diverse. While a shared sense of purpose and common goals bring many teams together, it can be difficult to connect with some personalities on a one-to-one basis.
In our experience, many difficult relationships or conflicts in the healthcare setting come down to a misunderstanding – often around communication and different ways of approaching a task. This can often have an impact on the cohesiveness of a team, but sometimes also on patient care.
A basic understanding of personality can help us to manage those relationships and create a smoother working life.
The study of personality
Personality has been studied for thousands of years and most of those studies break down personality into four dominant types.
Famously, Hippocrates based his theory of personality on four humours in the human body, which in excess, shortage or perfect balance affected a person’s behaviour.
These were later translated into representative elements - air, water, fire, earth - and this is recorded in some Aztec writing and later still into personality characteristics by Alfred Adler before we come to Carl Jung. Jung’s model has been widely used and appropriated in communication studies.
In 1921, Jung published Psychological Types, which studies personality and encompasses much of the work done prior to him. Much of the content of this article is founded on Jung’s work and the work that he inspired. For that reason, I call the styles ‘Jungian Archetypes’.
Jung started with two distinct types: extraversion and introversion. He illustrated these figures using the archetypal figures of:
Dionysus – Extraverted – External – People
Apollo – Introverted – Internal – Thing
Dionysus engages more with the external world than the internal and is defined as being focussed on people and relationships rather than things. Apollo seeks to understand the world, is more reflective and insightful.
This gives us four elements: extrovert, introvert, relationships, tasks. We can translate this into four personality types, outlined below.
Understanding personality types
No one is ever exclusively one type of personality – we’re a blend of different personality types, and we can re-deploy aspects of our whole personality to make communication easier.
However, we have one or more comfort zones – this is the aspect of our personality that feels the most natural to us. These comfort zones tend to be what ‘drives’ and determines how we interact daily.
No one is ever exclusively one type of personality – we’re a blend of different personality types.
Most people have two or more comfort zones and can slip between them depending on external factors. We may wear a certain aspect of our personality type more when we’re focussed on practising medicine and caring for patients, but another when we’re enjoying time with family or friends.
We’re also susceptible to hierarchical shift. In the healthcare setting, there is often a hierarchical structure where the most senior or experienced staff or clinicians will tend to be the driving force behind a team. This can often mean that we adjust to ‘fit in’ and find our place.
The four basic personality types are expressives, drivers, analytics and amiables.
Expressives: extroverted and people
Expressives are extroverts, fast-paced and lively – they bring energy and enthusiasm. They make quick decisions, often based on liking someone or something, and are direct and open in their interactions. They will often tell personal stories and anecdotes to stress a point. They form trusting relationships but will often be willing to take risks socially. They appreciate recognition and praise.
For expressives, relationships are more important than tasks. They enjoy working collaboratively and will take the initiative socially. They’re often bored by detail but good at seeing the big picture and creative thinking. When unhappy, they’ll be direct and often personal in their expression and will seek to apportion blame.
Expressives will often find creative solutions to problems. These solutions may not always be practical or realistic, but they will open the door to more lateral thinking.
Expressives tend to be the group that we see least of in the healthcare setting.
Drivers: extroverted and tasks
Drivers are the least common personality type. They’re highly assertive and dominant with a high sense of urgency – often they’re in senior roles and have little time. They require maximum freedom to make decisions, which they will make quickly and decisively. They’re task-focussed and driven by goals and outcomes and will respond immediately to choices or dilemmas. Drivers likes control and dislike inaction – if a situation appears to have stalled, they will either demand or take control of it given the opportunity.
We often see drivers in senior consultant roles and frequently in private practice, which allows them the flexibility and freedom required and frequently calls for decisive problem-solving.
Drivers often work well with expressives as they’re both extroverts and make fast decisions; they also work well with analytics (see below) who are often task and detail-orientated.
We usually see junior doctors with an analytic orientation. They will provide a wide range of findings with a driver colleague who will often help them arrive quickly at a treatment plan or a diagnosis. A ward-round scenario often demonstrates the relationship between an analytic and a driver. Drivers will fire questions and they will expect you to have answers to their questions.
Analytics: introverted and tasks
Analytics are detail-orientated people who will often want to consider all aspects of a situation and want background information to support any decision-making they may do.
Analytics rely on a systematic and structured approach to the world and are highly task-orientated, like drivers. Precision is essential to an analytic, who will listen and study information carefully before making any decision or diagnosis. Detail is king to an analytic, and time should be taken to study the detail and the context.
Unlike drivers and expressives, analytics are more introverted personality types and will let others take the social initiative, but are task-focussed like drivers, so a positive working relationship will normally ensue. Often, analytics will do the research and drivers make the decision. They work well as a co-dependent team.
Analytics can struggle to connect with expressives as they are often vague and imprecise and make decisions on instinct rather than evidence.
Amiables: introverted and people
Amiables are the most common personality type. They’re a more introverted personality type who demonstrate low levels of assertion and dominance. Their emphasis is on relationships, and they’re warm and focussed on others’ needs. They are careful, cooperative and highly empathetic. This is a group that is highly represented in the healthcare industry.
They will frequently build close personal relationships and will often be cautious in their decision-making process and feel uncomfortable when rushed – much like analytics.
Amiables work well with expressives because the focus is on relationships; they also work well with analytics as they share a slower pace and are likely to ask rather than tell. Amiables and drivers rarely get on; amiables will often view drivers as cold or rude and misunderstandings will frequently occur between them – not that they would tell them directly, but will often share their views privately with colleagues or in online forums.
We often see amiables in nursing, administrative and support roles as well as junior doctor and GP roles.
Adapting to others in practice
If you find you’re struggling to connect with or understand a colleague or patient, listen to the cues they give you as to how they communicate. The key to understanding any personality type is observation. We shouldn’t try and match others’ personality styles or mirror them – simply be aware of what their preferences are and adapt.
If a conflict escalates to a point where the GMC is involved, it’s important that you’re able to see the perspectives of others and voice your own concerns. This self-awareness and insight is an important communication skill that will help you to navigate new relationships – and is crucial to reflection.
Understanding how different personalities work using this model means we better understand our colleagues, rather than pigeonholing someone as grumpy, bossy or flippant. It helps us appreciate the people that we live and work with more, and understand that personality is determined by a sequence of preferences for how we interact. It’ll help you build better bonds with those around you and develop trust, not only within your team, but with your patients.
Tips for working with different personalities
- Listen to what they say – if they frame their communication with pleasantries, don’t ignore them, respond in kind as this is part of their communication process (this is particularly important with patients).
- Don’t assume that someone doesn’t like you or value you because they don’t show personal interest in you – it may be that they approach a task differently to you.
- If you feel that you’re not connecting with someone, ask for their opinion. This way you’re showing that you value them and their contribution.
- Adapt rather than react: always consider, ‘Who am I speaking with? What do they need? How can I subtly adapt my approach to give them what they need?’.
- Be aware of your own natural communication style, its strengths and limitations.