Patient Encounters 101: How to Seem Like You Know What You're Doing

The Med Student’s Guide to Faking Confidence During Patient Encounters

1. Mastering the 'Doctor Look'

• Confidence starts before you even open your mouth. Walk into the room like you belong there, even if your brain is in full panic mode.
  
  
• Stand tall, shoulders back, and maintain steady eye contact. Looking confident convinces the patient (and maybe yourself) that you know what you're doing.
  
  
• Wear a white coat with authority. Even if it’s two sizes too big, it still makes you look more credible.
  

2. The Art of the Firm Handshake and the 'Doctor Voice'

• Start with a strong but not bone-crushing handshake. It sends the message: "I’m in control here."
  
  
• Lower your voice slightly when speaking. The 'Doctor Voice' should be calm, measured, and devoid of nervous giggles.
  
  
• Speak slower than you think you should. A rushed answer screams, "I’m winging it!"
  

3. Nodding Sagely (Even If You Have No Clue What’s Going On)

• When a patient explains their symptoms, nod slowly and thoughtfully. It buys you time to process (or silently panic while recalling your notes).
  
  
• A well-placed "hmm" or "interesting" makes you look like you're putting the puzzle together when, in reality, you're mentally running through differentials.
  
  
• If you're really lost, repeat their last few words as a question: "You said the pain radiates?" This makes it seem like you’re analyzing deeply.
  

4. The Strategic Pause: Thinking Without Looking Clueless

• If you need a second to think, don’t freeze like a deer in headlights. Instead, take a brief moment to adjust your stethoscope, check their chart, or scribble something (even if it's just doodles).
  
  
• Say, "Let me process this for a moment." This makes you seem reflective, not uncertain.
  

5. The Power of Medical Jargon (Used Wisely)

• Toss in a few medically vague but impressive phrases. "Let’s consider a broad differential" sounds way better than "I have no idea what’s happening."
  
  
• "We need to correlate clinically" buys you time while you figure out if this patient really has something or just needs a snack.
  
  
• Be careful not to overuse jargon, or you'll sound like you're trying too hard to cover up confusion.
  

6. When in Doubt, Redirect the Conversation

• If a patient asks something you don’t know, instead of panicking, respond with:
  
  • "That’s a great question. I’ll check with my attending to get you the most accurate information."
    
    
  • "Let’s focus on your symptoms first, and we’ll circle back to that."
    
    
  • "I want to make sure we address everything thoroughly—let’s start with X and move from there."
    
• This prevents you from fumbling and reassures the patient that you’re methodical (even if you’re internally screaming).
  

7. The Confident Physical Exam: Even If You’re 50% Guessing

• Approach every physical exam as if you've done it a hundred times. Fake it till you make it.
  
  
• If you’re unsure about a maneuver, say, "I want to be thorough and check something real quick."
  
  
• Maintain a neutral expression even when you have no clue what you’re palpating. (Nothing gives away doubt like a confused face while checking reflexes.)
  

8. Avoiding the 'Rabbit Hole' of Unnecessary Tests

• A common mistake is over-ordering tests to compensate for insecurity. Instead of ordering "everything just to be safe," ask yourself: "What would a seasoned doctor do?"
  
  
• If you don’t know which test to order, phrase it as: "I want to approach this systematically. Let’s start with the basics and escalate if needed."
  

9. The ‘I’ve Seen This Before’ Trick

• Patients feel reassured if they believe their condition is routine. Even if you’ve never seen a case like theirs, say something like:
  
  • "This presentation is something we commonly see."
    
    
  • "I’ve come across similar cases, and we’ll go step by step."
    
• Even if your only prior experience is reading about it five minutes ago, this makes you sound knowledgeable.
  

10. When the Patient Asks, ‘Doctor, What Would You Do?’

• Instead of panicking, take a measured pause and say:
  
  • "I always consider the risks and benefits before making any decision."
    
    
  • "Every patient is unique, so my recommendation would be tailored to your case."
    
• This buys you time to think while making it seem like you’re deeply analyzing their situation.
  

11. Handling 'Google Warriors' Who Challenge Your Knowledge

• Patients armed with Google can make you sweat, but don’t let them see it.
  
  
• Acknowledge their research: "I appreciate you being proactive."
  
  
• Redirect: "Let’s focus on the medical evidence behind this."
  
  
• Never let them see you Googling something during the appointment (save that for after).
  

12. Dealing with Senior Doctors Who Sniff Out Fear

• Attendings can sense weakness like sharks smell blood. Keep your answers structured:
  
  • "Given the symptoms, my top differentials are X, Y, and Z. I’d like to rule out ABC with [test]."
    
    
  • Even if you’re unsure, having a framework makes you look prepared.
    
• If you get asked something and don’t know, say, "I’ll review that and follow up shortly."
  

13. The Exit Strategy: Wrapping Up the Encounter with Confidence

• Even if you feel like the whole appointment was a mess, leave on a strong note.
  
  
• Summarize the next steps clearly: "Here’s what we’re going to do."
  
  
• Shake hands, make eye contact, and exit the room without tripping over your stethoscope.