A colleague recently told me about an economist who spoke on “signaling” in the health care environment. Signaling is an academic term for how we spend resources to convey information about ourselves to others. The economist believes there are two main ways, or signals, that a physician demonstrates quality care to the patient. The first is to explain the diagnosis in clear, simple terms and answer any questions from the patient. The second? To wash his or her hands in front of the patient, before the exam. In all my years of practicing medicine, I routinely washed my hands in the exam room, but I wasn’t aware that it was a critical signal for the patient. I always saw it as a common-sense, respectful thing to do.

This conversation made me wonder what other signals are important, and what we do at Concentra to help create a positive patient experience. In short, what does the patient need from the doctor so that when that patient leaves, he or she says “They really care about me!”? One guideline we use in our continuing medical education program is the word SOFTEN, where each letter stands for an action that we have found improves the patient/doctor interaction. In addition to being a nice memory device, the word reminds us that simple behaviors can help reduce the edge of anxiety that some people feel when they’re in the doctor’s office:

Smile: Smiling is a courteous thing to do and, contrary to the belief of some, does not mean the clinician isn’t serious about his or her practice.

Open posture: An open posture communicates a willingness to listen to questions and thoughts.

Forward posture: Leaning forward engages with the patient; leaning backward creates distance.

Touch: Appropriate, occasional touching – like what you would do when talking with a friend – creates a positive therapeutic connection with the patient.

Eye contact: We tend not to trust people who don’t look us in the eye, and it’s no different when that person is a doctor.

Nodding: Nodding is a natural way to acknowledge what others are saying and to engage in the conversation.

Each of these actions is based on common courtesy, respect, and acknowledgment of others. Like washing our hands before treating our patients, they send the signal that we care about the well-being of our patients, and that want we want to create an environment of confidence and trust. All of this, we believe, helps motivate the patient to heal and return to their normal levels of functioning.

Signaling and Softening describe what a doctor should do, but more importantly, it’s what the patient needs. I welcome your thoughts on this subject.