Scott Finkelstein, MD wrote a piece for the website KevinMD.com last month entitled, In Medicine, Trust Needs to be Built in a Matter of Minutes. He relates how he was naturally shy in his youth, but now, is a fierce advocate for his patient and has grown to find that interacting with patients is the most enjoyable part of his job.
He points out a challenge about trust -- it is usually built over time, through shared experiences. As an anesthesiologist, though he has only a few moments in the perioperative process, to gain the trust of a patient and family when they are at their most vulnerable. His secret?
I give each patient my full attention. I maintain eye contact. I listen. I validate their feelings. I answer their questions. I educate. They understand. The fear melts away. And then they trust me. All in less than ten minutes.
Anyone who’s had a few surgeries probably knows that not every anesthesiologist takes Dr. Finkelstein’s approach. I actually recall an episode of hearing a voice of someone I’d not met, as they injected a very large needle into the back of my leg just before surgery. I firmly but politely asked “Who are you?” Only then did he formally introduce himself. He had made no attempt to gain my trust and I won’t be back to that facility. It’s not an uncommon experience.
Given our focus on outcomes and the patient experience, we can’t “hope” that every physician has the skills Dr. Finkelstein has developed. In the world of behaviors and selection, we’d specifically classify the behaviors – we can identify them, test for them and develop them. For instance, he displays high levels of (among other things); Social Awareness; Empathy; and Social Skills.
How do physicians develop these skills? Mostly by chance. We hope that somewhere in their clinical training, someone models these behaviors and teaches their importance. Yes, clinical and technical skills - the ability to diagnosis and effectively treat disease - remain the most important skills for physicians. There is ample research and anecdotal evidence though, that these behavioral skills impact the patient experience and outcomes – and they can be evaluated and developed.
Physician and nursing recruiters, leaders and educators need to begin incorporating these behavioral skills into performance expectations and the selection and developmental process. Gaining the trust of scared parents and children in less than ten minutes is asking a lot.