Authenticity and Incongruity

During a recent presentation at EMS Expo I spent quite a bit of time talking about incongruity. I think it’s an important concept to understand before you launch into learning tips and tricks for building patient rapport.

Incongruity is the act of being inharmonious in character or inconsistent. We identify it almost immediately in social interactions. For instance, say you’re on an airplane and you’re approaching the gate and the flight attendant quickly reads you a well prepared announcement thanking you for flying with their airline.

You know the one:

“We at UnitedContiAramriWest Airline know you have a choice of carriers and we sincerely…”

How do you feel? Do you feel like the flight attendant reading the message deeply cares about your business? How about when a sales person calls you at home to tell you you’ve just won a cruise? Do you yell for joy, “I won the grand prize!” or are you skeptical? “Where did I sign up for this contest?”

Ask yourself why that is for a moment? Why is it that the well thought out script of the telemarketer and the heartwarming thank you message penned by the airlines marketing consultant have such little effect. H0w does your brain identify the inauthentic so quickly? Why does it create the opposite of the intended effect?

The answer is incongruity; the subtle inconsistencies that we instantaneously register between the speaker and the message. If the flight attendant is trying to express appreciation, why is she talking so fast? If we really won the grand prize, why would they read us a script? Wouldn’t they only have to say it one time?

That’s incongruity. And you recognize it immediately, don’t you? And then you ignore the message. (Or get frustrated and angry.)

This is why patient rapport building techniques only work if you’re authentic. If you don’t care, you can’t fake it. Not with people who are having medical emergencies. The disparity between who you are and what you’re saying will leak through.

Here’s the short answer. If you want to be trusted, be trustworthy. If you want to be liked, be likable. If you want to be respected, be respectable. If you want people to feel cared for, be caring.

It’s really just as simple as that.

Now it’s your turn: Can you fake it in EMS? Leave us a comment and let us know.

Read More Pithy Observations:

Too Much Information

8 tragic EMS Behavior Flaws to Avoid

I’m Only An EMT Basic

6 Reasons Why You Should Be a Better EMT

Credibility and Redundancy


  1. Nicely said, Steve. You really cant teach people to be likable. But they can teach themselves.

  2. Steve Whitehead says:

    It’s true. It can be learned, to a degree, but we need to be motivated to have any level of success. Some folks go to patient rapport lectures because they’ve been told to do so by a supervisor or because they want to learn some sort of trick. There really is no trick.


  1. […] it comes to faking it, Steve Whitehead has Meg Ryan‘s number… do […]

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