Charm and competence among providers should ideally be concordant, but they can sometimes be discordant, which should be evaluated and corrected if possible. This discordance isn’t limited to health care; it can also be observed in politics, during litigation, and within families. Charming politicians can sway followers, charming litigators can sway juries, and charming family members can influence their families. Whether or not their competence, or lack thereof, gets overlooked is another matter. Charm’s effectiveness may stem from our evolutionary past, where humans might have used charm to survive within their communities, especially when lacking competence. The best combination for survival would have been both charm and competence, while the absence of both would have been the worst. It’s common for humans to have either charm or competence. Although this diversity is both genetic and environmental, societal conditions and personal survival necessitate lifelong learning to develop both charm and competence, even if with varying success.
Before this lifelong learning to combine charm and competence begins, there’s a lifelong evaluation based on feedback from others, including clients, customers, colleagues, coworkers, peers, patients, and providers, similar to how family members and commoners evaluate each other in politics. In health care, patient outcomes and feedback may sometimes reach providers directly or indirectly through other patient care team members, including physicians, proceduralists, nurses, staff, and administrators. Feedback from team members may be more valuable since well-functioning teams improve patient outcomes and satisfaction.
Whether anonymous or confidential, personal feedback from patient care team members can involve responses about whether team members find them charming enough to continue working together unless they haven’t worked together long enough to form an opinion and whether team members find them competent enough to recommend as providers for their family and friends unless they haven’t worked together long enough to form an opinion. If charm-competence scores from this feedback are positive and concordant, providers are on the right track and should continue. If scores are discordant, providers need to work on aligning charm and competence. If scores are negative for both, providers may need to prepare for imminent changes, whether forced or unforced, for their survival.
Providers can also self-reflect by asking if they find themselves charming enough to continue working in their teams and competent enough to recommend themselves as providers for their family and friends. However, such self-reflection can sometimes harm their personal health, making professional support necessary. Ultimately, the goal is to evolve both charm and competence to strengthen their concordance, even if previously discordant or non-existent, because survival depends on them in both prehistoric times and the post-modern future.
Deepak Gupta is an anesthesiologist.
