You must make a good first impression with patients


First impressions are critical. We are taught early in our careers that first impressions truly matter. Whether interviewing for medical school or a residency program, our goal is to make a positive first impression in hopes of making the cut at each checkpoint in our early careers.

These processes in our academic lives and careers are exhausting. As residencies and medical schools are becoming more competitive, the importance of first impressions has heightened. But once we achieve our career goal by being accepted and trained in our medical school/residency of choice, we must not forget that our quest to make a lasting, positive first impression endures. In fact, I would argue that the most important first impression to be made is with our patients.

Our patients deserve our best. And we need to be upfront with our intention to give them the best that we have. But how do we do that?

Each patient and patient situation is different. We, as physicians, encounter patients from so many different walks of life. There is no one “fit for all” script that we can adhere to when interacting with patients. This requires a great deal of flexibility on our part … not in the medicine that we practice, but with how we create and sustain successful relationships with our patients.

It is vital to keep every patient interaction as authentic as possible. In my experience, patients are very good at recognizing when we are disingenuous. This recognition can be on a conscious or subconscious level. This allows subtle negatives such as distrust and disengagement infiltrate a doctor-patient relationship. Patients either see us as invested in them as a whole or only as a check mark by their name.

And many times, we need to check in with our own conscious. Are there biases in our own heart that’s impeding the growth of a patient-physician relationship? Is any conflict in our personal or professional life bleeding into how we conduct ourselves to our patients?

We must make an intentional and conscious effort to identify any barriers that may be hindering us from delivering the best care we can give. Yes, we are trained to know guidelines and treatment protocols for various diagnoses. However, executing an excellent practice of medicine will not necessarily result in a successful relationship with a patient. And patients will not solely judge us by the success of their medical outcome — but by how we treat them as human beings.

In the day and age where the demand to see many patients in one workday is higher than ever, crafting the art of a meaningful patient encounter can be challenging. If the quantity of time we have is short, then the quality of our time is imperative.

But how do we create quality?

One answer is: control. Patients need a sense of control in the doctor-patient relationship. They need an opportunity to respond to recommendations and ask questions with regard to their care. No one likes to be “talked at.” We must always remember to “talk with” our patients.

The next key factor is identity. Patients want us to know their names. In Appalachia where I practice, our patients sometimes also want us to know the names of their spouse, children, and other relatives. Often times if I ask their occupational history, this gives the patient an opportunity to tell me about their military history or their time in the coal mines. By knowing their identity, you also provide the patient with a sense of validity. You acknowledge, embrace and know a few pertinent facts about their life and who they are.

Selective abandoning of empathy is also a useful tool. Perhaps I raise some eyebrows with this statement. Sometimes, we truly cannot identify or understand what a patient is going through. I have never endured a life-threatening diagnosis. I have never suffered the side effects of chemotherapy. When we say the phrase, “I understand,” in response to a patient’s illness, I think this isolates the patient more from us. I think it is truly hard for us to understand precisely what patients go through if we haven’t gone through it ourselves. But by the selective abandoning of empathy, we must replace it with assurance and commitment — assurance that we will do everything in our medical power to get them to wellness and healing. And the commitment that while we cannot understand the physical pains of their illness, they are not alone in their journey.

Last, but not least, the farewell. At the end of my service week as a hospitalist, I tell every patient remaining on my service that it was a privilege to meet them. I also take the opportunity to wish them the best with whatever medical illness they are battling. I shake their hand and/or the hand of their caretaker or relative. It is a chance to make a final, positive impression. I want them to know that while I am relinquishing their care to one of my colleagues, I continue to root for their success in overcoming their medical illness. By doing this, I let them know that I continue to care about their eventual outcome.

I hope in this article, physicians are reminded that the practice of good medicine is essential, but connecting with our patients on a human level is also important.

In the words of Maya Angelou, “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

Remembering this is what will elevate us to the practice of great medicine.

Andrea Lauffer is a hospitalist.

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