Beyond First Impressions - November 2023

Beyond First Impressions - November 2023

Reprinted with permission from the Business of Primary Care, https://www.thebusinessofprimarycare.com/, a great resource for leading primary care practice, November, 2023

A friend of mine went to a clinic visit with his wife recently to support her in getting screened for depression. The medical assistant came out to the waiting room to get them - with blue hair, a nose ring, multiple tattoos, and a gender vague name tag to match their demeanor. Walls went up automatically.

And yet… This MA showed care and concern, even sharing that they had “been where you are” with depression, reassuring my friends that they had come to the right place for help. In the end my friends said, “All that exterior stuff fell away. What mattered was that they were able to convey compassion.”

First impressions have always gotten a lot of attention, but I’m going to push back a bit and suggest that what happens after that first impression (aka unconscious bias) might need more focus. This MA, I’ll call them “Bleu,” was able to create a safe space for the patient and family member that overcame their initial judgment. Let’s explore how they did that, and how you and your team can focus on this too.


  1. Build psychological safety. An employee who feels heard, appreciated, and valued by their leadership is in the right place to recreate that safety for patients. Safety is knowing that someone has your back, and an employee who truly feels your support will represent you well with patients. Build safety with employees by soliciting and listening to their ideas, by sharing your own stories, and creating relationships of trust with them. Role model and reward risk taking – meaning sticking your neck out to share new ideas, going the extra mile, trying something new to make a process better. Psychological safety is the platform to –
  1. Foster a sense of belonging. Bleu may not “fit in” with their style, but being accepted for who they are, they can experience that sense of belonging. Would your employees say, “I’m supposed to be here,” when they talk about how they experience the workplace? It matters. “The Value of Belonging at Work,” from Harvard Business Review (Carr et al., 2019) confirms that workplaces with a high sense of belonging have a:
  • 50% Drop in Turnover Risk
  • 75% Reduction in Sick Days
  • 56% Rise in Job Performance
  • 167% Increase in Employees Willingness to Recommend

Some actions you can take to build that belonging culture:

  • Start with making a big deal of socializing them even before they start. Have a manager or preceptor meet new employees for coffee before day one to get to know them.
  • Build your preceptor program so they have support from their peers.
  • Use stay-interview questions regularly, for example, “What is one thing that would make you still want to be working here in one year? What is one thing that would make you not want to?”
  • Engage your team in a discussion: “How can we all create a sense of belonging for everyone? What actions can we take that show we accept people for who they are?” They’re more likely to embrace the ideas when they are empowered to come up with them.
  1. Show compassion. Compassionomics https://www.compassionomics.com/ reveals research that truly communicating compassion takes about 40 seconds and that is a minute that matters. Even though we hear the phrase “compassion fatigue,” true compassion doesn’t cause burnout; lack of compassion does. Compassion connects us, empowers us, and gives us hope. When you show compassion – and foster the demonstration of it in your team – it improves patient engagement and compliance with treatment recommendations. That leads to better patient outcomes and impacts the bottom line. Bleu made their compassionate connection that made the difference with my friends when they said, “I’ve been where you are. It’s hard. You came to the right place, and we’re going to be with you to get through this.”
  1. Build competence, which leads to confidence. Patients will sense staff confidence and be reassured by their competence. We expect a LOT from folks on the front lines who have significant initial interaction with a patient. Hard truth – whatever you are doing to onboard new employees, double it. Triple it. Invest in increased onboarding, mentoring, buddy system for learning, and time allotted to learning. I know, everyone is busy. But if you want to retain people, create a workday where they can shine and use their best talents confidently.
  1. Manage up. Lead the way in shining light on your colleagues. Start team meetings or huddles with, “Who has someone they’d like to recognize today?” It may start quietly, but once you get rolling, people will get that we look for the good and it will reinforce it. Then it becomes easier for someone like Bleu to say, “You are going to see Dr. X today – you are in such good hands. Dr. X is a patient favorite because they have a ton of experience in helping people see the light at the end of this tunnel of depression.” This is an incredible skill to build patients’ trust in us, and it’s one we can teach people to do meaningfully when it comes from a place of trusting relationships.


What’s after the first impression for you and your team?  

Find your way to the Business of Primary Care podcast with my interview on strategic leadership https://www.thebusinessofprimarycare.com/podcast/jo-anne-preston



Jo Anne Preston In Jo Anne's current role as Organizational and Workforce Development Senior Manager at the Rural Wisconsin Health Cooperative (RWHC) her aim is to offer to leaders straightforward tools and inspire the courage to use them.
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