Bad first impressions can ruin the whole consultation.
Previously, I have explained how precious the very first seconds in any new encounter are. This is the time, when the tone for the entire encounter is set!
For a bad first impression, we only need to look at the typical start of the interaction between the doctor and the patient.
The typical start of the doctor-patient interaction
We all have seen this unfold, when the child with the parent come to the reception of the clinic.
They get sent to the waiting area, and there they wait and wait and wait. This prolonged waiting in itself will increase their level of anxiety. If they are lucky, this place has some toys, if they are unlucky, the waiting area is just boring. A boring waiting space will aggravate the sense of anxiety in the child about whatever lies ahead. The parents will also become increasingly tense, as they will try to keep the bored child calm. This in itself is an almost impossible task.
But, bad first impressions can ruin the whole consultation.
Making waiting are more interesting
Distractions in the waiting area as simple as soap-bubble machines would help to reduce the anxiety in the child and support the parent during the wait.
In contrast, the challenge with a very enticing waiting area could become evident when the doctor calls the family. It might be difficult to leave this place behind because it is so much fun!
More about this will follow later!
How do we get the patient to the consultation room?
The next “first impression” will be the entry of the examination room. And as said before: bad first impressions can ruin the full consultation.
Frequently, the patient and parent learn by either a screen that shows what room they need to go to, or a nurse who picks them up and directs them to the consultation room. Often the first encounter with the doctor takes place in the consultation room. This would be for them very unfamiliar territory.
As soon as they enter the office, they see the doctor at the desk, often frantically typing away notes from the previous patient. There is never enough time for administration, so we utilize every possible moment. The attention of the medical specialist goes to the screen and the keyboard, hardly noticing the new arrivals. If the parent and the child are lucky, they receive a “welcome” and a “have a seat”.
You cannot not communicate!
This statement stems from Paul Watzlawick. Communication happens constantly! Even though the health care provider does not talk to the arrivals, they learn that whatever the doctor is doing right now is far more important than them. They are immediately put in their place: “Don’t dare to waste my time!” This information has been shared non-verbally!
After arriving in the consultation room, the paediatric patient, is generally asked to sit next to the parent and to wait some more. Then the adults start talking among themselves.
What does the child “hear”?
Now the child becomes even more bored and increasingly anxious. When the doctor finally turns to the child for the examination, the child has learned that he or she doesn’t count.
At this stage, the inner voice of the child might sound like this:
- The time of the doctor is precious, my time is worthless.
- The computer is more indispensable than me, why should he/ she look at me.
- My task is to wait, and I have no say in how long.
- I am hardly visible; the adults deal among themselves with everything.
- Whenever the doctor wants to examine and to touch me, I have no say.
Bad first impression, and then?
Of course, we are frequently reassessing our first impression. On the other hand, it takes less energy to stick with the first judgement than to alter it. This is called confirmation bias. It seems we are hard-wired to follow this bias to save energy. And with this pre-judgement, we fill in the blanks accordingly. Therefore, the downside of a negative first impression can hardly be overemphasized.
Bad first impressions can ruin the whole consultation.
How we “use first impressions”?
The results of our mental shortcuts are:
- The more we liked the person in the first place, the more we tend to like them better during the encounter.
- But also, the more we are irritated by the other person initially, the stronger we find ourselves confirmed in our negative prejudice.
Prejudice?
I say prejudice because that is what it is.
The base of data for our initial decision is very limited, but regardless, we must come to a judgement about the situation.
How the child gets close to me?
When I meet the parents and child in the waiting area, the child is often made to walk or worse, dragged towards me. Because the parents seem to assume, that all that the doctor wants, is for the consultation to get started as fast as possible. The parents mistake speed for efficiency.
What does the child see?
I am the stranger! The child is forced towards a stranger. Unfortunately, after being pushed, carried, dragged this way, the child’s fear can easily escalate into a state where he or she shuts down and might entirely refuse any form of interaction with me as a measure of self-protection.
Summary of “routine first impressions”
When we shift into a helicopter-view of the scene of the “normal” first meeting with the doctor, it becomes obvious that the first seven seconds are regularly just wasted. In my opinion, this is a shame. The chance for a productive base for the consultation, the chance for connection, is frequently neglected like this, and I will describe my ideas about an improved first contact during the upcoming weeks.
But be assured: You won’t have a second chance for a first impression!
In a nutshell:
The typical rundown of an outpatient appointment tends to lead to more to trigger fear and to hinder cooperation.
Bad first impressions can ruin the whole consultation.
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