Earning Patient Trust in the Minutes Before Induction

by Samita Islam

Growing Up Around Hesitation with Healthcare I grew up in Atlantic City, in a community where people didn’t always feel comfortable navigating the healthcare system.

A lot of conversations sounded the same.
“I’ll go if it gets worse.”
“I don’t want them to find anything.”
“They don’t listen anyway.” 

It wasn’t always about access. Sometimes it was hesitation. Sometimes fear. Sometimes just the feeling that the system wasn’t built for you. 

At the time, I did not recognize how much those observations would shape the way I think about patient interactions. It was only after entering the operating room, particularly on anesthesia rotations, that I began to see their relevance more clearly.

Anesthesia as a Unique Moment of Trust
In most areas of medicine, trust develops over time through repeated interactions. In anesthesiology, that process is compressed into a matter of minutes.

Patients meet the anesthesiologist shortly before surgery and are asked to entrust them with their airway, their breathing, and their consciousness. There is little opportunity to build rapport gradually. The interaction immediately preceding induction becomes the foundation of that trust.

Observing this dynamic shifted my attention from the technical aspects of anesthesia to the subtleties of communication in these brief but critical encounters.

Language That Builds Reassurance
What stood out most was how deliberate anesthesiologists were with their language.

One attending consistently introduced themselves by saying, “Hi, I’m Dr. ___. I’m going to be with you the whole time today.”
This simple statement directly addressed a concern many patients have but may not verbalize—who will be present and responsible for their care while they are unconscious.

Similarly, when patients appeared anxious, a resident would often say, “My job is to keep you safe and comfortable. I’ll be here watching everything the entire time.”

The reassurance was clear and specific, and the effect was often immediate. Patients appeared more at ease, with less visible tension and fewer lingering uncertainties.

Even subtle changes in phrasing influenced how patients responded. Instead of asking, “Do you have any questions?” one resident frequently asked, “Is there anything you’re worried about going into today?”

This wording invited patients to share concerns more openly, often revealing fears about not waking up, experiencing pain, or losing control. Another commonly used question was ,“Do you feel comfortable with the plan?”
 
This shifted the focus from comprehension alone to emotional readiness.

Nonverbal Presence in the Preoperative Encounter
In addition to language, nonverbal behaviors played a significant role.

Anesthesiologists who connected effectively with patients often positioned themselves at eye level rather than speaking while standing over the bed. They paused after explanations, allowing patients time to process information, and maintained focused attention during the interaction rather than dividing it between tasks.

These behaviors conveyed presence and attentiveness, reinforcing the reassurance provided through words.

Why This Matters in Anesthesiology
Reflecting on my early experiences, I began to recognize that many individuals are not avoiding healthcare due to lack of information alone, but because of discomfort, uncertainty, or prior negative experiences.

In anesthesiology, where time is limited, these underlying concerns must be addressed quickly. Communication in this setting is not simply about delivering information; it is about creating a sense of safety in a short and often high-stakes interaction.

This has direct clinical implications. Anxiety can manifest physiologically, affecting heart rate, blood pressure, and overall perioperative experience. Effective communication, therefore, is not only patient-centered but also contributes to smoother induction and overall care.

What Medical Students Can Learn Early
For medical students, it is natural to focus on the technical aspects of anesthesia, including airway management, pharmacology, and physiology. However, these early interactions offer an opportunity to develop an equally important skill set.

Students can begin by observing patterns in how different anesthesiologists communicate.
Noticing which approaches consistently reassure patients—and which do not—can provide
valuable insight.

There are also practical steps students can incorporate into their own interactions:

● Introducing themselves clearly and stating their role: “Hi, I’m a medical student working
with the anesthesia team today.”
● Asking open-ended questions such as, “Is there anything you’re worried about going into
today?”
● Offering simple, immediate expectations: “You’ll feel the mask on your face and take a
few deep breaths,” or “You may feel a little drowsy in a moment.”
● Using reassuring, specific language: “We’ll be with you the whole time and watching
everything closely.”
● Allowing space for patients to respond rather than rushing through explanations
● Maintaining eye contact and minimizing distractions during conversations

These small adjustments can meaningfully improve patient comfort, even in brief encounters.

Carrying These Lessons Forward
I am still learning how to navigate these interactions effectively. However, my time in the operating room has made it clear that the ability to build trust quickly is a fundamental component of anesthesiology.

The experiences I had growing up did not teach me how to practice medicine, but they shaped how I recognize hesitation and respond to it. In anesthesia, where patients are at their most vulnerable, these insights become especially relevant.

In the moments before induction, patients make a rapid decision about whether they feel safe. How we communicate in that time can influence that decision in a meaningful way.