One thing you must master to be an effective doctor is never taught in medical school. It builds trust and bonds patients to their doctors. It opens the door for honesty and real talk.

You must master: Authenticity. 1/21
The majority of medical training is designed to crush your authenticity.

You are taught to be clinical, professional, appropriate, evidence-based. Freshly minted robots without any identifying marks. 2/21
Patients hate this shit. We are here to talk about sickness, fear, life and death. We aren’t looking for a mild mannered customer service representative.

We are looking for a fellow human being. 3/21
Generating authenticity requires revealing bits about yourself. 4/21
Don’t be afraid. No matter how hard you try to hide your true self from your patients by hiding behind the guise of a healthcare robot, you reveal your nature anyway. 🤖🤖🤖 5/
In fact, authenticity is created when you show you know who you are. When you reveal a bit of who you are and show how it is consistent with the way you move and the decisions you make. 6/
My patients know I am a straight talker. A country boy raised in Ohio who went to fancy schools. They know why I am a doctor—to fix problems in people without considering whether or not they can pay. 7/
I didn’t start authentic. I started off with “no acute events over night” and nobody could remember they ever saw me.

It was exhausting to play the robot and not very effective in changing people’s lives. 8/21
So I started to experiment. Revealing more of who I am and where I came from and also more of what I think is important and why.

These are called my values. Sharing your values makes you authentic. 9/
Telling your patients your values is not paternalistic. Quite the opposite. It is an invitation for your patients to tell you their values.

To be two authentic free-standing people in the room together. 10/21
From there, you can have a real talk about where you agree and disagree. What matters and what’s important.

Being authentic puts you and your patient on a equal footing. Two people exercising lordship over their own body and mind.

Now we can talk. 11/21
Authenticity is not indiscriminate. You will make mistakes revealing too much or the wrong things about yourself. Some patients will try to use what they know about you against you.

Don’t give up. Just adjust. Not everybody can know how many kids I have. Use good judgment. 12/21
Like any skill, you will make mistakes and you will learn.

Here’s what I’ve learned: 13/21
Patients appreciate knowing how my parents died and how it felt for me to work with doctors while they died. 14/21
Patients like to know about my pets and my four daughters and the joys and challenges of both. 15/21
Patients like the know what matters to me and why I became a doctor. They like to see me teach and know that there is no other way to make physicians. 16/21
Patients like to know that I love my job and that I worked hard to get where I am and I work hard every day to do good work fixing up their sick bodies. 17/21
Patients like to know that I have fun and love my days. Each day is a gift and wise people never miss an opportunity to enjoy the day and the people they meet in it. 18/21
Patients like to know that I don’t like people who slow me down or stand in my way. And I have lots of tricks for getting around, over, or through those kinds of people. 19/21
Patients like to know that I am curious about them and honest about myself. I am an authentic human being first who happens to work as a doctor. 20/21
Be authentic. Find a way to be yourself. It will make your days easier, more fun, and more effective. 21/21
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