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    How being a nice guy plays out in the workplace

    Does it pay to be disagreeable or aggressive in the workplace?


    Peter J. McDonnell, MD
    A loyal Ophthalmology Times reader, who is a big fan of Miss Manners, sent me an article about deportment in the workplace. "You should write about this in one of thosee ditorials of yours," she said. "It shows that jerks get more money."

    The article1 describes a study performed by three professors from three universities (Cornell, Notre Dame, and The University of Western Ontario) that examines the relationship between self-reported "agreeableness" and financial compensation. "Agreeableness" is apparently more or less a synonym for how nice a person is; the antonym would be rudeness.

    The study finds that rude men earn 18% more than nice men, while rude women earn about 5% more. That translates into about $9,800 more annually for the disagreeable men, and$1,800 more for their female counterparts.

    "Nice guys are getting the shaft," says one of the authors.

    Further, men who were described as highly agreeable were less likely to be offered a job as a consultant in a study of hiring preferences. And to add insult to injury, the researchers say that men being agreeable does not conform to "expectations of masculine behavior."

    Why would jerks get more money?

    There may be a number of explanations that the study authors (or I) can think of:
    1. Agreeable people don't negotiate as vigorously for salary.

    2. Our society might think that rude people must be smarter or otherwise worthy of more money.

    3. Perhaps high performers become cocky and rude because they truly are outperforming their co-workers (think Steve Jobs). In this scenario, it is not the rudeness resulting in higher compensation, but the stronger performance resulting in both higher incomes and associated inflated egos leading to disagreeable behavior.

    Certainly, we all have known doctors who are jerks. But we should forgive the rudeness if they are talented surgeons, right? Afraid not.

    According to studies of surgeons,2 rudeness and incivility in the operating room lead to poorer health outcomes and even higher death rates. And rude doctors who make an error in prescribing are less likely to be questioned by nurses or pharmacists —who naturally wish to avoid interacting with someone who will likely retort in a rude manner to any inquiry—and this means that the patients of rude physicians are more likely to suffer from negative medical interactions or receive the wrong type or amount of drug.

    In a survey of 1,500 medical students, 42% claimed they had been harassed by superiors and 84% reported being belittled. According to Andrew Klein, MD, of Cedars-Sinai Hospital in Los Angeles: "We are essentially training the next generation of surgeons to be bullies."

    Being a nice guy (like watching episodes of "How I Met Your Mother") may be unmanly, but in this age of pay for performance, when it comes to physicians the evidence tells us that we should be paying the nice ones more, and not less, than the rude ones.

    Some ophthalmologists may beg to disagree. They may argue that it is important to be feared by one's staff and nurses in order to get them to do their work, and that being rude and aggressive at work is effective. To them I say, "take a hike!"

    References

    1. Silverman RE. Hey, you! Mean people earn more, study finds. Wall Street Journal. Aug. 15, 2011.

    2. Park A. Your doctor's bedside manner could affect your health .Time. July 19, 2011.








    By Peter J. McDonnell, MD director of the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of Ophthalmology Times.

    He can be reached at 727 Maumenee Building 600 N. Wolfe St. Baltimore, MD 21287-9278 Phone: 443/287-1511 Fax: 443/287-1514 E-mail:

    Peter J. McDonnell, MD
    He is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of ...

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