The goal of seeking out healthcare is to resolve one problem or another. Who wouldn’t want to see the very best, most competent practitioner around? How can the image of competence be better portrayed than through exuding confidence?

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A Dental Specialist Says

I get to see the quality of many practitioners’ work. The most interesting phenomenon about how many doctors are perceived by their patients is through the confidence they exhibit. I know two fellows in particular who had enormous practices and their patients’ loved them even though they may have been the most incompetent guys I ever knew. What they excelled in was confidence. It was unbelievable how many of their patients thought they were with the best doctor around.

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Since competence and confidence are not always paired together as they should be, we must recognize that the purpose of this discourse is not to fool the unsuspecting public by explaining how to express confidence. It is however incumbent upon every practitioner to have the utmost confidence in everything they do to improve their bedside manner and to provide the finest possible experience for each and every patient.

Even the effectiveness of placebo has been show in studies to be enhanced by the confidence/bedside manner of the practitioner. In The Annals of Internal Medicine, 4 June 2002, Vol.136, pg. 817-825, authors Eisenberg and Kaptchuk discuss the performance of "healing ritual" as part of the patient-practitioner interaction and how it may affect healing. As practitioners, we have an obligation to make sure our rituals" are filled with compassion and confidence, as they not only build your reputation and practice, they help to heal your patients.

The best way to have confidence is to know your field to the nth degree. Be able to answer every question posed to you. And when you don’t know the answer, make sure it is because no one knows the answer. No one wants to go to the doctor who can’t answer their questions or the one who stammers or seems stumped by the questions and has to contemplate the answers. If you truly know your field of practice, and have been doing it long enough, you probably heard most every question that could be thought up and that is where experience helps.

It is interesting how the confident, incompetent practitioners seem to be able to answer all the questions even when they don’t know the right answers. The reason lies in the fact that they quite often give the wrong answer with such confidence that they are never questioned further or second guessed. Since their patients love and trust them, they are not inclined to get second opinions. They are not inclined to seek redress when things go wrong.

Besides knowing your field like no one else, you have to convey your confidence to the patient. Remember, there are some exceptionally talented and bright practitioners who have such poor bedside manner that if someone didn’t tell the patients that this doctor is the best, no one would go there.

CONVEYING CONFIDENCE

To convey confidence you have to be a good communicator and that is why communication ties in so well as one of the bedrocks of bedside manner. Confident communicators offer all the information necessary for the patient to feel they are making an appropriate choice in their selection of you and the procedure you recommend.

When offering treatment options, make sure you have an opinion about that which is best. The confident doctor is not afraid to guide the patient. The last thing you want to appear is wishy-washy. Guiding the patient doesn’t preclude your responsibility to offer all options of treatment as part of the informed consent, it just means that you aren’t afraid to tell the patient what you think is best.

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A Patient’s Story

I needed to have back surgery and I went to this one guy who told me it would definitely help and that he too needed to have the same surgery. He then told me, “In truth, I’m afraid to get it done, and I keep putting it off.” Naturally, I went for a second opinion, especially because I could barely walk. The next guy was very direct. He told me I definitely needed the surgery and even showed me how my leg was getting weaker and the muscle was shrinking. He told me that he had it done and is doing fine. He did warn me of the downside consequences, but clearly stated that doing nothing in my case was more of a risk for permanent problems. The thing I liked best and sold me on him was when he said, “You don’t have to get this done by me, but you need to get it done.” I schedule right then to have it done the next week, No need for any more opinions for me.

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Looking directly at the patient when you speak is a good trait for communicating and even more important in expressing confidence. Confident people don’t look down at the floor. Naturally there are times you are writing notes in a chart as you speak, but try to pay close attention to the patient and engage them with your eyes.

Have your pitch well rehearsed. Make sure it answers all the questions you’ve heard a thousand times. If the patient is sharp and has no questions by the time you are done you have communicated well and in a most confident manner. If you really excel, don’t be surprised if they keep asking questions and encourage other conversation because they are so delighted with your manner and presentation.

There are two ways to convey confidence. One couples with compassion while the other couples with authoritarianism. Both work with differing personalities. Some patients like to put their doctors on pedestals and actually feel good when the doctor speaks in an affirmative manner. Picture the older doctor looking down so his eyes peer above bifocals balanced on the tip of his nose as he delivers his directives.

Others prefer the doctor whose confidence is built into a deeper level of compassion. This doctor can speak softly and slowly in a manner that exudes confidence with the compassionate touch. Each practitioner has to exhibit that type of confidence that best suits his personality and taste.

YOUR REPUTATION

An indirect way of engendering confidence in your patients takes place before they walk in your door. This occurs as a result of your reputation. Patients often rely on recommendations from friends, family, and especially other professionals. Everyone likes to go to “the best” and when they hear the same name popup time and again, they have confidence before they even meet with you. Never take your reputation for granted and never miss the opportunity to develop it. Be a great doctor and the word spreads.

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The Secretary

We’re referring you to Dr. Jones. He is amazing. He treated me and my husband. As a matter of fact, he treated Dr. Smith too, and that’s why he sends all his patients to Dr. Jones.

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There used to be a concept in healthcare called professional courtesy. It was a common, unwritten rule that doctors would treat each other without fees. This practice has dried up in many instances. It seems that everyone wants to make a lot of money and they don’t consider how offering colleagues a courtesy may be appropriate.

There is one bastion of professional courtesy that remains and that is providing free care for those who refer patients to you. It has become a matter of quid pro quo today with the expected gain associated with catering to your source of patients.

While it is sad that so many behaviors are associated with self-interest that is often the case. It is wise to at least know that professional courtesy for your referring doctors as well as their family and staff members means they will generally be loyal to you. When they recommend you and tell their patient how great you are, it becomes an immediate endorsement that goes a long way in enhancing your reputation even though it may have nothing to do with your abilities.

If you treat your patients with all the pillars of great bedside manner and you are truly great at what you do, your reputation will grow without relying on who you treat for free. Then you can offer professional courtesy because it may just be the right thing to do.

CONFIDENCE IN THE FACE OF ADVERSITY

Confidence is needed more than ever when things go wrong. There are certain risks with most every treatment modality in every field of practice. Instruments break, tissues don’t always heal, and treatments fail. Things don’t always go well.

You must rehearse your explanations of untoward results and present them with confidence. This way you will have less negative repercussions.

When an instrument breaks, it is much better to have a sound, logical explanation and solution that you present with all the confidence that portrays the event as something within the realm of reasonable possibilities. Contrasted with a panicky presentation that tells the patient you messed up; confidence wins every time.

Areas of adversity differ with each field of practice. If you deal with life and death issues, you must have a script for telling loved ones that the patient died. A lesser case of adversity may deal with a failed procedure. The more important the procedure, the more difficulty the explanation. It is much easier to tell the patient the scar on their back isn’t fading than telling the patient the heart transplant has failed. Remember no matter how trivial the loss, compassion must remain a constant.

No matter how trivial you may value the adversity, every case warrants a good, and especially confident explanation for why things didn't work out as planned.
The informed consent that specifically explains many of the complications of treatment helps make your explanation of a failing procedure that much more acceptable. And when delivered with great confidence, the patient is more likely to accept the outcome.