WHAT MAKES SOME PHYSICIANS SUCCESSFUL?
What makes some physicians successful? Some are good-looking but not successful. Some physicians lack smart looks but are astute practitioners. Every one of us has same physical dimensions; the eyes, hands, ears, legs, palms, fingers and vocal cords; but still each one of us has a distinct performance.
Success depends on knowledge coupled with application of body language.
Body language is like ‘autobiography’ in motion. It is a broadcasting station that works round the clock and keeps on relaying signals to the outer world uninterruptedly. Hence, a physician should act like an antenna receiving all the signals of varying frequencies. Every smile, every frown, every syllable a physician utters has an impact.
It is unfortunate that communication skills are not taught in the schools or colleges. ‘It’s never late to learn, however.’
Here are some important tricks.
THE FIRST IMPRESSION
Simply, be ‘open.’ To get others to open up, you must first open up to them. Keep a good attitude. Be retrospective and aware of your own body posture. First impressions are indelible. The way you look, the way you move and make gestures are more than 80 percent of first impression.
Appropriate presentation of your personality is the key to make a striking first impression.
Following vocabulary helps for successful communication, facilitation in interrogation and projection of self.
- Taking coat off
- Taking sunglasses off
- Moving closer, but not too close
- Leaning forward
- Uncrossed legs
- Arms gently crossing lower body
- Repeated glances
- Open lipped smiling
- Small upper or inward smile
- Erect body stance
- Hands open, arms extended, eyes wide, alert
- Lively and bouncy voice, well-modulated
- Slightly titled head
- Sitting in front portion of chair with tipper torso forward
- Hand-to-cheek gesture
- Stroking chin or pulling beard
The physician must coordinate himself in listening, talking, observing the patient and observing his own body language.
DRESS AND APPEARANCE
Lack of concern about appearance has a negative impact on the patient. Being unshaven, smelly or shabby, disgusts others. A neat, clean and ironed dress appropriate to the profession of a doctor projects an elegant image! Never wear anything sloppy, tight or revealing to the patient. Make sure your shoes and other accessories are clean and polished. Be sure your hair is clean and well groomed.
Your clothes need not be expensive. They should be suited to your shape and style. They need to represent you at your best and you as well as your patient should feel comfortable.
This should give a positive demeanor. Do not cross your arms in front of the patient, or cross your legs away from the patient you are talking to. Face to face interaction with a patient is a must. Erect posture is recommended while standing. Stand evenly on both feet. Keep the arms relaxed and casual. Don’t slouch, but don’t stand up in a stiff way. Adopt forward leaning while taking the interview of the patient. Don’t lean forward or lean backward too much.
Don’t be dramatic and unnatural. Your clinic is not a film studio. Don’t sit or stand in an awkward position. It is always better to be in responsive and reflective modes of body language.
MAINTAIN EYE CONTACT
Eye contact is one of the most powerful of all skills. Sounds simple, yet it’s a common omission. There are two skills for active listening-eye contact and head nodding. Converse at the eye level of a patient. You should know when and how to maintain eye contact.
Persistent gaze at the patient can make him embarrassed. If a patient is rendering important information, don’t break the eye contact even after he has finished talking. Lack of eye contact gives the impression that you are talking at people instead of to them.
It helps the patient to know that you consider him as a person. A pat on the back, a light touch on the shoulder can be reassuring to the patient.
However, you must know the culture too. Touch can be a risky proposition. You must be cautious and if your selection or even timing is wrong, perhaps you may receive a slap.
Remove physical obstacles between you and your patient. These are masks, safety glasses, gloves, bibs, flower arrangements, books, desktop computers or laptops, etc. Such objects clutter the visual space between you and your patient. Even air is an obstacle if there is too much of it.
Communicate ‘barrier free’ with the patient. If you want an unconstrained conversation, get rid of any obstacles. Some physicians have the habit of keeping a hand on the mouth while talking. This also acts as a barrier. Not giving a pause to listen to the patient is a major barrier.
Remember, the first and foremost barrier is you.
Blend of openness, smile, eagerness and interest with sincerity works wonders. A gentle and pleasant smile does the trick. A long smile can look forced and nervous. Remember, mere smiling is not enough in today’s competitive world. How you smile and what is your motive behind it also carries importance. When a patient says something funny, respond to it by laughing but don’t be the first to laugh at your own jokes.
Facial expressions should be lively and cheerful. Morose and melancholic face of a physician may discourage the patient.
Remember the phrase ‘The pen is mightier than the sword but the tongue is mightier than the pen’. Keep a polite tone. Polite physicians are always winners. Speak slowly and articulately.
A physician should use resourceful words like-wonderful, nice, good, very good, elegant, stunning, ravishing, how beautiful, a good explanation, splendid job, great, good efforts, you are clever, you are planner, smart, how caring you are, superb, extraordinary, fantastic, how sporty, interesting, right, magnificent, remarkable, glorious etc. Conversely, while reacting to the grief and sadness, the physician should use the words like – how bad, a bad experience indeed, it must have been a painful experience for you, very sad, what a tragedy etc.
Be expressive but without overdoing. Be open, but not to the point of being contrived and affected. Do not fidget, scratch, twitch, wiggle or squirm in the front of a patient – try to avoid fidgety movements and nervous ticks.
Avoid ‘commando’ postures such as hands on the hips or clasped behind the head. Avoid ‘barrier’ language, such as turning your body away or keeping your arms folded. Avoid exuberant or frantic movements. Be sure your words and your body language match. The patient needs undivided, uninterrupted and unhurried attention from a physician.
A physician must respect the territory of a patient. Generally, the personal space extends to about the distance of an adult’s outstretched arms. If it is invaded deliberately, it can make the patient uncomfortable, embarrassed or threatened. Research has shown that individuals who do not respect others’ space are less popular and are often rejected by the people.
The physician should see that his inner animal doesn’t come on to the surface.
One of the criteria of follow-up should be change in the body language of a patient. A physician should observe the facial expressions, eye expressions and the mode of talking in order to decide if medicinal action has been registered on the system.
Remember, simillimum changes the body language by bringing harmony in the patient.
YOUR OWN AURA
Be aware. Self-awareness requires multi-sensory integration. The first person you need to impact with positive body language is not others, but yourself. You must know your own aura, the electro-magnetic energy field created by your body.
Remember Osho’s statement, “Trust and respect the intelligence of your body and that will lead you, in turn, to a sense of grounding and centering.”
NEED OF CONSTANT POLISHING
The art of knowing and using body language can’t be learnt within a short period. It needs constant application by training yourself to be a keen observer of people. Spend more time with people. That’s the best way to learn and understand them.
This will help you to identify your own body language, which has an incredible impact over your patients. Be a choreographer tuned to the needs of your patient and you will follow the central tenet of individualization.
Patient-physician communication is an integral part of clinical practice. ‘Qualitative communication produces a therapeutic effect’ is a fact that has been validated in controlled studies. Avoiding communication pitfalls and sharpening basic communication skills help strengthen the patient-physician bond that many patients and physicians believe is lacking in this busy modern life.
I end up this article with a realistic statement from George Bernard Shaw, “The problem with communication is the illusion that is has occurred.”
- Body Language and Homoeopathy, Ajit Kulkarni, B. Jain Publishers, New Delhi
- Patient-Physician Communication: Why and How, John M. Travaline, MD; Robert Ruchinskas, PsyD; Gilbert E. D’Alonzo Jr, DO, Journal of the American Osteopathic Association, Jan 2005
- What Doctors are telling us even when they’re not talking, Pauline W. Chen, M.D., Doctor and patient, Feb 2012