Truth, Lies and TV Myths: A Body Language Expert Weighs in on Authenticity from the Exam Room to the Board Room



In observing his physician father’s bedside manner, Scott Rouse became captivated by the world of nonverbals and body language. Today, Rouse is an acclaimed behavior analyst and body language expert who has trained and consulted with law enforcement, the US military and government agencies. He also works with corporations to do everything from identify con artists to help CEOs communicate more effectively with their employees.

We recently sat down with Rouse to discuss one of his favorite workshop topics – body language and bedside manner – to understand what healthcare leaders need to know and ensure that they’re communicating authentically.

How do you define authenticity?

The same as most people, I think…Is what you’re seeing in someone’s behavior real? Is it what it should be? And how do you feel about that person or situation?

When a doctor deals with his or her staff, are they motivated? Do they believe the doctor cares about them and the patients? How do they know? When staff feels as though they are in a “family” or on a “team,” that’s where you find a doctor who is authentic. When a patient has bonded with and trusts their caregiver, that’s where you find a doctor who is authentic.


People are constantly watching and analyzing. Every employee is scrutinizing leadership for signs of authenticity. Caregivers and clinicians are looking at patients for signs of a problem. So, be real in every situation, even if “real” means being honest about uncomfortable truths.

Are there definitions of the word that you disagree with?

Yes. Someone who thinks being authentic is, “I don’t think about what I’m going to say – I open my mouth and whatever comes out, comes out.” To me, that says they aren’t confident, or they’re not concerned with what comes out of their mouth. They think authenticity is “saying what’s on your mind.”

When the truth about a patient’s situation is a bit tough to talk about, and the doctor gives the diagnosis like he’s reading a lunch order at Denny’s, that’s not being authentic. That’s being rude.


Don’t be an ass. Don’t shoot from the hip. Be thoughtful, even when the truth hurts – think about that jerk of a surgeon who bluntly tells a patient he needs to lose weight before surgery.

What are the physical hallmarks of someone who is being authentic?

Someone who’s being authentic or truthful is going to look comfortable. When you’re trying to decide if someone is being honest with you, if they’re being themselves, you’re looking for those differences between comfort and discomfort. When a person becomes uncomfortable, they’re not being themselves.

For example, if you’re being truthful with an answer, you don’t want that delay in answering to be too long. That’s because when you lie, three things happen in the brain:

  1. You have to stop the reflex action of telling the truth. Your brain says, “Whoa, hang on, you can’t say what really happened.”

  2. You have to create the lie. You have to make something up that you think the other person will believe.

  3. You have to deliver the lie – the situation that didn’t happen. That’s where you’ll see the pause that’s a little bit too long. Everything is in the delivery.

All this happens very quickly for the most part. But you’ve got to be able to gather and decipher that nonverbal information being shown to you to decide what’s really going on.


Be prepared for the hard conversations and tough questions. Don’t fall back on dissembling or lies.

Are there misconceptions about how to determine whether someone is being authentic or truthful?

You don’t want to rely on most of the things you’ve heard about deception and body language, even from so-called experts on TV and in magazines. For example, “He looked down and to the left so that means he’s lying,” or, “She broke eye contact when I asked her if she knew about the problem with the filing system.” Those are not valid body language cues when it comes to deception.


Since most of what pop culture has trained you to think about cues and tells is incorrect or incomplete, don’t rely on those in everyday conversation. Instead, get better educated in the science of nonverbal behavior and body language. We’ll do Scott a favor here and suggest you start with some of the materials on his site.

How does a leader’s authenticity look and feel from the perspective of an observer, such as staff in the auditorium?

If they’re on stage they’ll usually be a little uncomfortable at first because they’re in front of a room full of people and are reciting, remembering and focusing on what they’re supposed to be talking about.  So, they may try to do things they’ve heard about to look confident. But if these are things – like movements or gestures – that they wouldn’t normally do, their comfort level will drop even lower. And the audience will see that discomfort.

You’ve got to take those things into consideration – which most people do when watching a speaker in front of a large audience – and give them a bit of room when it comes to authenticity. The person may be as authentic and honest and into it as they can possibly be, but they may still look as though they’re not.

Since we’re talking about healthcare here, the person speaking is most likely either a doctor or someone from the C-suite. That person is probably analytically-minded. Standing behind a podium reading their notes and looking up every now and then may be what they’ve always done. So while they’ll feel more comfortable, they may look a bit odd as it isn’t their usual place to be reading from those notes.


We’d all love to be that slick TED speaker with 43 million views on YouTube, but most of us don’t have that kind of skill. Don’t be afraid to lean on aids to help you communicate. Prepare well, practice to look as comfortable as possible, and then just be yourself.

And, ideally, learn to get out from behind the podium. Walk around a bit. Use open-handed gestures. When you do that, you look more trustworthy and approachable.

What about differences in personality and behaviors for someone who isn’t naturally warm but aims to be authentic?

This can be fixed fairly easily.  Especially when you know what to do and how to practice looking a bit warmer and more approachable. For example, most people are under the impression that crossed arms mean the person is closed off, not interested. In reality, though, it means absolutely nothing most of the time. That said, when you don’t cross your arms and do use open-handed gestures, it makes all the difference in the world to the person you’re talking to.

When someone is talking to you, tilt your head to the side with your “good ear” just a bit toward the other person. Shake your head up and down just a little bit every few seconds. Keep your eyebrows up. Doesn’t sound like much, but just those three little things will make the person feel you are really listening and interested in what they’re saying. 


With a little practice, using just the simplest of nonverbal cues can help you communicate with most anyone a little better. Developing new skills doesn’t mean you’re being inauthentic – you’re just becoming a better you.

There’s a ton of research showing that authenticity as a practice trickles down from leadership to staff. Is that psychological, physical, both?

I tend to lean toward psychological.  Everything begins with and is executed by the brain. People want to mimic, mirror and be like a charismatic leader. People like – and want to be like – someone similar to themselves. That’s the root of charisma (or “presence”), which is a potent additive to the leadership role.

What does this look like? It’s when you’re authentic with your staff. When you show you’re the leader.  When you treat each one as an individual. When you show respect and give them the feeling that they are part of a team or a family? That’s when you begin to gain trust and when they feel your leadership and are motivated.

So it’s not just nonverbals, it’s also your verbal approach. “Be pleasant” is easy to say. But what does that really mean in the real world?  Here’s where the doctor has the advantage… This is where, once again, bedside manner comes into play.  If you have a good bedside manner, being pleasant, looking trustworthy, giving the feeling of confidence and motivating your staff will be easy. You use the very same skill set.


It’s no secret that your actions and attitude have a huge bearing on your staff. And leadership can be lonely. Don’t isolate yourself from your team. Be honest about what’s going on, ask for support and invite people in to what’s going on.

How can healthcare professionals adapt their environment to be more comfortable and make things more comfortable to the people around them?

My father is a doctor. His bedside manner is what got me into the world of nonverbals and body language. He explained to me why babies stopped crying when he picked them up. He taught me how to make people who are extremely sick feel comfortable and at ease very quickly. He showed me how he knew when someone wanted to tell him something, but for whatever reason, wouldn’t or couldn’t give him all the important information he was asking them about – and then how to get them to give him that information while feeling good about it.

Today’s healthcare professionals are experiencing changes like never before, causing stress for patients and staff. The doctor-patient connection is being severed by technology, leading to a phenomenal number of lawsuits and failing practices. The way things are now, by the time the patient leaves the waiting room they’re dang near livid when they get in to see the doctor. Those medical practices that haven’t mastered the art of a truly authentic bedside manner are beginning to suffer. And most of them have no idea why.

I can tell you this from my experience. My doctor’s office changed so much from the time I was diagnosed with thyroid cancer to the time I was coming back for my last few checkups. It was two COMPLETELY different healthcare experiences. So much so that I created an entire keynote and a workshop on what those problems are and how to fix them while keeping and utilizing all the new tech being used for patients. It’s that bad and that obvious that something has to be done.

Most doctors don’t realize that authentic bedside manner begins in the waiting room. When the patient first walks through the office door. And there’s a specific way to approach that problem.

It’s key that you make the human connection because that’s going away. The people who are making decisions are seeing it from an analytical perspective, not the doctor’s or perspective and certainly not from the patient’s perspective.


Start with the patient. Any healthcare professional – from LPNs to health system CEOs – should talk about the patient first using patient-centric language. It’s a long-term play, but returning focus to the patient may help individuals connect better and more authentically with the people they serve, and also push the healthcare system towards better care.

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As Jarrard Inc's Content Marketing Manager, David Shifrin specializes in curating ideas and making technical concepts accessible to broad audiences, helping thought leaders move past jargon to present core messages in a meaningful way. He received his PhD in Cell and Developmental Biology from Vanderbilt University.