HealthManagement, Volume 19 - Issue 6, 2019

Summary: Medical Professions Consultant, Annemiek Nooteboom, discusses how subtle changes in your body language can have a profound effect on interactions with healthcare colleagues throughout your career.

What are the benefits of approachable leadership and what impact can this have on the hospital system?

Approachable leadership is very effective because it will strengthen the bond with your staff and also effortlessly bring you the information you need to lead your organisation. When the professionals on the work floor feel that they can approach their leader at any time, patient safety and also the educational and team climate will improve.

How important is learning appropriate body language in the soft skills set?

It is important because a lot of professionals are unaware of the effect of their own body language, which is a missed opportunity because body language has such a great impact within a fraction of a second. It is the fastest, cheapest, most effective – or most ineffective – way to communicate with your surroundings. Once you know how to use your body language, it is much easier to connect with the people around you.

How does body language play a part in how new and more seasoned clinicians are perceived by other healthcare professionals?

Many young and relatively inexperienced doctors have a reflex to make themselves invisible because they feel insecure or insufficient. This makes sense because, as humans, we instinctively tend to withdraw in on ourselves when we are exposed to a lot of new and unknown stimuli. For example, when you enter an ICU for the first time, there are lots of new sounds, machines, complex patients and you will be surrounded by many experienced nurses and clinicians. This might be overwhelming for a while, which causes most junior professionals to retreat and this is visible on the outside through their body language.

It is important to resist the urge to do this because it might negatively impact the amount of contact you have with other professionals and will slow your learning curve. It is better to display confident body language right from the start. You can behave more confidently by standing firmly, taking up more space physically and speaking with a clear and sometimes even loud voice. By implementing these actions, you will instantly feel more secure on the inside.

For experienced clinicians, it is the other way around. They often are unaware of how much they are admired, and sometimes feared, by their subordinates. They don’t realise that other professionals will not dare to ask them a question or tell them if they have a doubt. In this case, it’s important to display more open body language, making it easier for juniors to approach senior staff members.

Can inefficient body language impact a clinician’s career and if so how significant can this be?

Nowadays, it is common practice for medical professionals to be evaluated through 360-feedback. In their report, they can read comments about their educational qualities and they can learn how they are perceived by residents, nurses and interns. Sometimes I am asked to coach doctors that have gotten less positive feedback. When I observe them, it often strikes me that they are actually not bad educators or bad people, but they have something about them which is intimidating, scary, angry, grumpy or arrogant. This behaviour doesn’t always represent the person’s character. In many cases, it has become a habit or adopted attitude but can have a major impact on their relationships with colleagues.

When you seem closed off and colleagues think “he/she doesn’t want to talk to me” or, “thinks I’m inferior” or “they’re always busy,” a psychological barrier is created. This barrier doesn’t easily disappear because people find it very hard to give spontaneous feedback until they are obligated to create a written report. We don’t have the habit of telling each other “what you just said made me feel like I’ve done something completely wrong” or “you shouting at me in the OR stresses me out” or “you make me feel like I’m not a good nurse.” This whole dynamic can create a lot of miscommunication. The professionals who seem less closed off can create an open channel of communication between them and their colleagues, creating fewer conflicts and frustrations.

What changes can clinician leaders make to become more approachable to junior staff members, both in general and through body language, and what is the significance of implementing these actions?

I would recommend for clinician leaders to take half an hour per day or a couple of hours per week to walk around, greet everyone and engage in some informal talk. When you establish an informal space at unbothered moments with your staff, they will find it much easier to tell you difficult issues at critical moments.

Professionals on the work floor have essential knowledge about successful and unsuccessful patient care processes. They also know about the interactions and ongoing quarrels between colleagues that a leader has no clue about. There are a lot of interesting dynamics taking place on the work floor and it is easier to lead your department when you are aware of everything that goes on.

I often recommend clinicians with a formal leadership position to let themselves be addressed informally, for example, you can have yourself be called by your first name instead of your full academic title. As senior staff members are already overly admired, and sometimes feared, this change does not impact the way people respect these leaders. This might seem like a small change but it has an immensely positive effect by lowering the threshold for staff to talk to you.

In terms of body language for leaders, it is important to display a relaxed, non-authoritarian attitude. If you tend to take up a lot of space with your body, hands, gestures and your voice is loud, you will seem authoritarian and dominant. Many leaders are good speakers and they ‘transmit’ all the time, they don’t listen enough. When you sit back and switch from transmitting to receiving – listening, observing and start to absorb everything that’s going on – you will receive significantly more information without much effort.

How can new physicians change their body language to establish themselves within the hospital system?

This is exactly the opposite of what senior leaders should do. New physicians should make themselves bigger, literally. Taking up more space with your body is really easy to do. For example, putting an arm on an armrest and not putting your arms in front of your body all the time.

As a young physician, you can position your body in a way that looks comfortable and confident. For example, put your legs hip-wide apart and increase the space between your arms and your body. I have seen immediate effects after initiating these strategies with a lot of young interns and residents.

Also, when you are walking or doing rounds, it is important that you don’t stand at the periphery, put yourself in the middle of the conversation. Everyone should be involved in the discussions and make eye contact with each other while standing in a big circle. During rounds, it is common for the fellow and supervisor to be doing all the talking while nurses, interns and residents listen without participation. The seniors should try to include every professional around the bed, including the patient, and the junior should put themselves in a position where the senior can look into his/her eyes.

What advice would you give to clinicians starting their healthcare career?

First is, realise that you are not the only one to feel insecure, almost every young doctor experiences this feeling, which is only natural when you are surrounded by all these experienced people. The difficult thing is that nobody in the hospital talks about it, so everyone thinks they’re the only one feeling inadequate. The second piece of advice is to talk to each other. You will soon discover that many young clinicians feel the same. If you experience a lot of anxiety, speaking to a coach can help. Thirdly, use all you have at your disposal, including your body through body language, your face with all its possible expressions and your voice.

For more information, lectures and training programmes, you can contact Annemiek at [email protected] or visit

«« The Value of Discount on Branded Drugs

Winners of the IHF Awards 2019 »»