As a physician in cosmetic medicine, the consultation room is where the money is made, or lost. Getting patients means developing a level of trust. However, what holds many physicians back is fear.

 
In helping physicians develop a consultation that builds trust in a patient, it's clear that fear plays a pivotal role in the success or failure of your consultation and your practice. It's simply the fear of rejection.

Because of this, many physicians try to put the entire responsibility for every decision on the patient, just what the patient doesn't want.

It becomes obvious that some Physicians are afraid that putting forward options and real recommendations will place them in a position where the patient may recriminate them sometime in the future or reject them.

Or, some doctors use an 'aggressive' consultation and are defensive about any question the patient asks. (These are the doctors that 'talk down' to their patients.)

Then there are physicians who can perform a nearly perfect consultation that not only manages patient expectations, but creates a deep sense of trust and deep loyalty in almost every patient.

“Why?” is what I always ask.

There’s an obvious answer to that question: the physician exceeded the patients expectations, the patient liked not only what she heard, but what her 'radar' told her, she signed on and the physician notched up another paying client.

The important thing is that the physician didn’t give in to their fear and instead just did what was needed, overcoming fear of looking foolish or having the story rejected. And often that’s just what needs to be done.

First impressions are important, but that can also result in spending too much time trying to perfect that first contact. Remember the words of surrealist Salvador Dali: “Do not fear perfection for you will never achieve it.”

Fear of Looking Foolish or Being Rejected

This is not uncommon and is all personal ego but I'm often surprised to see it from physicians with twenty or more years of experience.

Common sense is really what’s needed to avoid looking like the fool. Make sure that you're aware of what the patient's been told and what their understanding is before you go in the consultation room. Make sure that your staff is aware that if there's anything out of the ordinary (it's a problem patient, they're a friend of so-and-so, they were treated at another clinic, whatever) they're to make sure you know this before the consult. The physician should be just as cognizant and actively question the front desk as to the situation before a consult

Problems arise when the physician or a staff member states something in conflict with what the patient expectations are or what they already understand. I've seen many physicians simply dismiss something that another staff member has told a patient to avoid the awkward embarrassment of seeming uninformed or wrong. The patient just ends up confused or thinking that the clinic as a whole is unorganized and that either, some other staff member doesn't know what's going on, or the physician is an ass.

One physician I dealt with entered every consultation with the phrase "Have we met before?" in order to put the onus of introduction on the patient. While it protected the physician from having to initiate conversation or admit he didn't remember the patient, the patients (many of whom were regulars) felt unappreciated. The staff was again left to pick up the pieces.

 Patients, for the most part, are quite willing to take on the responsibility of their own decisions. The closest analogy I can think of is a singles bar. Everyone's there to get picked up. Just don't let your fears let you go home alone.