I haven’t done a medicine post for a while ever since I did investments. There’s been so much work and uncertainty in healthcare and I have been busy home renovating, working, and writing. I’ve barely posted anything on the website for a while.
Today we’re talking about compassion in medicine. It was while I volunteered at a hospital when I was at a lecture that I realized there was a problem with having compassion in medicine.
I was there to act out a patient role for staff teaching. And so I ended up having to listen to the day’s events. One of the things being “taught” was how to be compassionate.
They even had a technique on what statements to make when you talk to the patient. Heart- head – heart statements; so that you sound more compassionate.
Why? Because of the bottom line. Several insurance companies were handing out payments based on patient feedback. And patients were looking for compassion.
Why is Compassion in Medicine Eroding?
I was amazed to find that Universities are now having separate lectures to teach medical students compassion. I find it strange. Do we have to teach people to be human? Has society changed so much that we need to train people to be nice?
As I was researching for this article, several medical organizations have pointed out that having compassion will improve outcomes and improve patient adherence.
Did that require a study? People do more when they feel you’re invested in them. There’s a lot of evidence that the brain can identify compassion distinctly from empathy.
So why aren’t we more compassionate in medicine?
In A Hurry
You have to finish your entire new patient physical in fifteen minutes as per the EMR/ Patient Managers/Whoever Rules Your Practice. There’s no time to be compassionate. Heck, there’s no time to ask anything other than the name and date of birth just to make sure you’re dealing with the right person whose EMR is in front of you.
In a study at Princeton, students who were restudying Divinity were divided into batches. Each of them was asked to deliver a sermon on the Good Samaritan. Each was given one of three instructions. You’re late, It’ll be a few minutes or the assistant is waiting, please hurry over. There’s a sense of hurry in each statement. The students on their way to give the sermon, encounter a man bent over in pain. Yet, none of them stop to help. The reason is hurry. The more pressed they were, the less observant they were.
When we’re pressed for time our cognitive map narrows. We just want to get the job done.
There’s So Much To Do
There’s a lot of ground to cover. Fill the script, take the history, examine, plan the tests, make referrals, fill the note, fill the right code, give a shot if necessary, enter those details, etc. The more you have to do, the less is our aptitude for compassion. There’s plenty to accomplish because it’s not the patient but all the additional powers that be that we have to please.
Too Self Focused
I’ve seen in many patient encounters, physicians are too self-focused. Instead of listening, they often share their own experiences. Patients don’t want to know how you’re battling something. They’ll figure things out. They want you to listen to them as they go through something.
I’m not sure why but plenty of physicians are simply looking to boost their egos. You see this on social media all the time. If physicians show some compassion, they’ll make an entire post about it and look for validation. Our patients cannot and will not serve our egos. Their people like us. Suffering people.
We’re Afraid
We’re afraid of what people are going to tell us. The deep, dark, dirty details that some people let us know can be scary. We don’t know what to do with this information. We’re scared people will ask us for help. And we can’t extend ourselves to every single person. So we shut conversations down, ignore questions, and pretend to have heard their story while we’re busy going about our own work.
Patients Have No Boundaries
Once they start talking, they don’t stop. That’s not always the case but older patients generally don’t understand that there’s limited time. They’re coming from the period when doctors weren’t looking at the computers. They were talking to them and listening to them. They were invested in their families and their outcomes. Times have changed. Many medical professionals prefer to have clear patient boundaries and rightly so.
Can We Be More Compassionate?
I’ve watched so many styles of doctors over the years and here’s what I’ve learned from the compassionate ones and their practices.
Preparation is Key
The more experienced a physician is the more they prepare. I’ve noticed that the more seasoned ones come in early and start going through all of their cases before the day has even begun. They’re not reviewing the file for the first time in front of the patient. They’re ready and they’ve taken the time to go through the previous labs, the necessary tests for today, any referral notes, etc. So when the patient walks in they’re not wasting time flipping through tabs but are able to talk to their patients and listen to them.
Listen To Patients
Don’t listen because you have to respond, just listen to them. I remember when I go to see my dentist, the same one I’ve been seeing for the last 17 years, she will take the time to ask what am I doing and how things are at home. She went above and beyond to try and help me when my dad passed away. She didn’t have to and I didn’t need help but she was moved with compassion because of my circumstances at home. The thing was she listened to me, even though she had so many people waiting outside. I am usually very private but she encouraged me to talk and she listened.
The Power of Touch
I cannot tell you how many people complete clinical visits without touching their patients. It conveys so much. Examine your patient. Lots of people live alone. They’ve gone so long without a hug. When I had an abscess, I went to urgent care. I knew the follicle was infected and the abscess would have to be incised. The doctor first said, “I think I know you’re a medical professional,” and then as I mentioned where I graduated, he had already lain me down, had me on my side, and positioned, with subtle touches here and there. I didn’t even realize it.
Explain What Needs to be Explained While Sitting Down
The same doctor then went on to explain where he would make an incision n my arm and why. How he would try and prevent a scar from forming etc. Most patients are more compliant when you take the time to explain what’s going on. Let’s operate on a level where people are intelligent. I remember when my dad died, the doctor didn’t even tell me his name. I had no idea how he died except that they had begun CPR. We stood (not even seated) while he gave me this news. To this day, all I know is what is written on his death certificate.
Sit down with your patients. When you stand, it translates that you’re in a rush and that you’re above them. Eye to eye, seated, helps. Explain until they understand. Make them repeat what you’ve said. I’ve seen so many people come to their PCP where a specialist has explained the procedure to them but they have no idea what was said.
Read Non-verbal cues
No one wants to come to a hospital. There are better places to be. Most people are anxious, afraid, and nervous. Respond to those cues. Address their concerns. Eyes, hands, body language, convey something.
Don’t Pass the Buck
If there’s a problem, we tend to pass it onto another doctor, let the FP make the referral, let someone else write the prescription, let someone else figure out what went wrong in the pharmacy, or why they haven’t shown up for an appointment. Instead, we should be solution-oriented. Your patient has a problem, what can be done to fix it. Can you ask your admin team or medical assistant to help them out? Can your office have a customer service rep?
Compassion in Medicine Is Not Easy
The longer the days in medicine, the harder it seems to be compassionate. You get tougher, put more distance and detach yourself from people’s problems. That’s how you survive feeling pain or overextending yourself. Let’s not forget, we’re human too. Let’s do to others what we expect done for ourselves.