In an era of increasing demand for gathering data, performing to metrics, and doing more with fewer resources, are we losing sight of compassion in health care? Burnout is certainly common among all providers -- physicians, nurses, and allied health professionals alike. But how can we make sure we aren't losing sight of the kindness and empathy patients truly seek?
Professor David Haslam, an accomplished physician in the United Kingdom, recently published a debate article in the Journal of Compassionate Health Care in which he emphatically argues that physicians must always deliver compassionate care.
What Is Compassion?
Haslam borrows a definition of compassion from the National Health Service in the UK: "the humane quality of understanding suffering in others and wanting to do something about it." Most health care providers would agree this is an essential part of medicine, if not one of the primary reasons for entering medical school, yet the question of whether this personal understanding is necessary in health care or merely an "optional extra" still exists.
Individual physicians have always displayed differing levels of compassion. One challenge in today's fast-paced world is that, despite having a definition, it's not easy to create a checklist of how to deliver compassionate care. However, when we or our loved ones receive services, we know whether we felt heard, understood, and cared for.
How Compassion Gets Lost
How do we lose our view of the individual person when dealing with patients? In his article, Haslam argues that relationships are harder to form because of busyness, lack of continuity with patients, and team-based care that lessens a feeling of responsibility toward the patient.
Compassion fatigue is another reason. It's a form of burnout, with care providers dealing with their exhaustion by withdrawing and becoming less empathetic. This fatigue develops from increasing demands to see more patients in less time, cut costs, and maintain or improve quality, all while balancing the demands of operating a business.
A loss of empathy may come even earlier in a doctor's career. One study found that medical school students already showed a decrease in empathy between their first and third years.
How to Get It Back
On one end of the spectrum, you must collect data on your patients, improve outcomes, and meet a range of quality and safety metrics. On the other end, you must provide patient- and family-centered care, achieve good patient-satisfaction scores, and be culturally sensitive.
It's tough to get to know each patient in a 10- or 15-minute office visit. What do you need to do to provide compassionate care every time?
Engage With Your Patients
Keep in mind the reasons patients are coming to you; it's more than simply fixing their medical problems. A survey conducted for Dignity Health found that 87 percent of Americans value kindness above other considerations, and 90 percent would consider switching providers if they received unkind treatment. This is at a time when patients have a wealth of information available to them about physician experience, quality, and outcomes.
Haslam also gives specific suggestions on how to improve care. He advocates for "performing medicine with patients rather than doing it to them." This means understanding their wants, fears, ideas, concerns, and expectations.
Sit down during patient visits, make eye contact, and ask questions that engage the patient in their treatment decisions. These simple actions show you care without adding time to the encounter.
Change the Culture
It's easier to operate in an office with a compassionate culture. Most organizations are focused on their scores, but compassion needs to start at the top. Haslam argues against impersonal, task-based care. Leaders need to be empathetic and encourage and recognize those values in their care teams.
Take Care of Yourself
Compassion fatigue will likely still occur. The rigors of being a physician aren't going to change anytime soon. To combat burnout and do the best you can for your patients, remember to take care of yourself. Take time off to recharge when you need it. Do something daily that helps you feel fulfilled.
Compassionate care is, and always has been, a fundamental expectation of patients receiving health services. It's understandable for providers to lose sight of the individual in front of them with so many expectations and so little time. However, compassion is necessary to keeping your patients happy, healthy, and engaged.
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