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7 ways a smile can be great medicine for you and your patient

Smiling provides stress relief and can improve the provider-patient relationship, benefiting care


In this Aug. 31, 2011 photo, Eagle County paramedic Kevin Creek checks the blood pressure of James Duke, 64, during a house call to his home in Eagle, Colo.

AP Photo/Ed Andrieski


Steve Wirth, Esq., EMT-P, is an EMS attorney and founding partner of Page, Wolfberg & Wirth, which represents EMS agencies throughout the United States.

By Steve Wirth, Esq., EMT-P

In the opening scene of the 1970s television show “Fantasy Island,” a small plane lands on an isolated tropical island with several prominent guests who are in for a high-end, life-changing vacation in paradise. As the guests exit the plane, the resort manager, Mr. Rourke (played by Ricardo Montalban), reminds the staff that first impressions are very important. He issues the command: “Smiles, everyone, smiles!” Simple and to the point. In other words, be on your best, be positive and make the customer experience a positive one.

A professional exudes confidence and truly enjoys the work they are doing. So much so that it is very apparent to those around them. It’s one of the reasons Southwest Airlines always gets high marks for customer service – the entire staff, from gate agent to flight attendant, to pilot, truly act and behave like they really like working there. This positive demeanor is always accompanied by a smile. It makes the customer experience so much easier – and it puts you at ease and makes you feel like the most important person on the plane.

These same concepts apply to EMS. We want our patients to feel that they are the most important person during that experience. Smiling can help improve the patient experience, reduce the risk of a lawsuit, and help us manage our own stress.

Smiling is great for stress relief

Research now shows that the simple act of smiling causes positive physiological changes in our bodies. Smiling releases endorphins in our brains that make us feel good. And the best part is that it is the physical action of smiling that generates this positive effect – not the reason behind that smile. These positive changes occur even if we’re not smiling or laughing at anything particularly funny. Even forced laughter can have the same effects – your body simply doesn’t know the difference.

Erin Coleman, R.D., L.D., described seven positive physiological effects of smiling that can help us deal with the unique stresses of today’s world:

  • Improved mood. Smiling simply makes us feel better and improves our mood. And it is infectious. If one person smiles, it is likely that those around them will want to smile too.
  • Lower blood pressure. Smiling is shown to have a calming effect and thus lowers heart rate and blood pressure.
  • Stress relief. When things aren’t going so well, smiling can help us deal with the stress and remind us that we shouldn’t sweat the small stuff. Keep smiling – even during stressful situations to help remain calm and keep the heart rate and BP down.
  • Better relationships. It is hard to argue with someone who is smiling, unless they are smiling just to get you riled up. When we smile, we are more likely to respond to others with positive, rather than negative words. People generally respond positively to others who smile, and smiling can be a very useful tactic in disarming a stressful patient encounter.
  • Stronger immune function. Studies also show that our immune systems can be boosted by smiling.
  • Pain relief. Facial expressions like smiling can actually divert our mind’s attention away from the pain. The Mayo Clinic reports that laughter and smiling causes the body to release its own natural painkillers.
  • Longer life. Happy people tend to live longer and enjoy life well into their retirement years. They are also the most likely to have a positive outlook on life. This in itself is a good reason to smile!

Smiling is an effective risk management technique

At the beginning of the patient experience, the first 30 seconds are the most important. That is when the patient is going to decide whether he or she believes you to be a competent and caring EMS practitioner or not. These early seconds set the stage for the rest of the encounter.

Making a positive physical approach to the patient – and smiling as you introduce yourself – can help give the patient a positive first impression. Smiling with a patient can provide the patient with much-needed relief of some of their stress.

Smiling also helps patients remember the positive aspects of their experience. The bottom line is that patients are less likely to sue you if they like you – even if you make a mistake in treatment.

Patients are much more forgiving if they feel that you truly cared about them and made them your center of attention. Smiling is one way to exhibit the positive attitude that shows the patient that you truly care. And as a side benefit, smiling reduces stress and can help keep you out of court.

About the author

Steve Wirth, Esq., EMT-P, is an EMS attorney and founding partner of Page, Wolfberg & Wirth, which represents EMS agencies throughout the United States. He was one of central Pennsylvania’s first paramedics and has worked as a firefighter, EMT, paramedic, flight paramedic, EMS instructor, fire officer and EMS executive.

You can reach Steve at or 717-620-2681.

For over 20 years, PWW has been the nation’s leading EMS industry law firm. PWW attorneys and consultants have decades of hands-on experience providing EMS, managing ambulance services and advising public, private and non-profit clients across the U.S.

PWW helps EMS agencies with reimbursement, compliance, HR, privacy and business issues, and provides training on documentation, liability, leadership, reimbursement and more. Visit the firm’s website at