Journal Article
Randomized Controlled Trial
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The power of the pen: how to make physicians more friendly and patients more attractive.

Medical Education 2016 December
CONTEXT: Studies have shown that patients' subjective perceptions of physicians' competence and friendliness are relevant aspects of a successful treatment, influencing patients' well-being and trust in the physician. Psychological research has repeatedly shown that unconsciously contracting muscles that are usually used to smile can intensify and even elicit positive feelings (known as facial feedback). Empirical evidence also suggests that a smiling person is favourably judged by others with respect to attractiveness and trustworthiness.

AIM: This study's purpose was to investigate how an induced muscle contraction, similar to that of a smile, affects physicians' interactions with a standardised patient. It was expected that the 'smile intervention' would affect physicians' and patients' perceptions, resulting in higher ratings of the friendliness and attractiveness of physicians in the intervention group.

METHODS: Twenty physicians participated in the randomised controlled study (10 male, 10 female). Physicians were randomly assigned to one of two conditions: an intervention group (performing an easy cognitive task while smiling; n = 11) or a control group (performing an easy cognitive task without smiling; n = 9). Afterwards, physicians had a 5-minute consultation with a standardised patient. This consultation was subsequently rated by physicians, the patient and an external rater using 10-point Likert scales.

RESULTS: Physicians in the intervention group were rated as significantly friendlier by the external rater (mean 7.81 versus 7.11; p = 0.097, η(2)  = 0.15). In addition, physicians in the intervention group rated the patient as significantly more attractive (mean 6.91 versus 4.78; p = 0.017; η(2)  = 0.28).

CONCLUSIONS: Our results suggest that physicians can influence their friendliness and their perception of patients' attractiveness. Thereby the 'power of pen' can be an efficient method for making the hospital a friendlier place.

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