In this day and age, when Americans seem always to be at each other’s throats, when ridicule outstrips respect, when the national conversation has been hijacked by blowhards and bullies, it might be time for the rest of us to show a little moxie and demand a return to civility. And health care might be just the place to start.
True or false: All doctors are arrogant and abrupt, all nurses are mean and bossy and everybody else who works in the hospital just wants to get their shift over with so they can go home and forget about it.
We all know that's a crock. I've met plenty of health care professionals who understand that treating people well means not just treating their illnesses well but also treating them well as fellow human beings — as people not just patients.
And yet there are too many others in health care who apparently still don't get it. A survey of 800 recently hospitalized patients and 510 physicians published in this month's Health Affairs found widespread agreement that compassionate care is "very important" to successful medical treatment. It has been shown to impact clinical outcomes, patient and family satisfaction and even costs. However, only 53 percent of patients and 58 percent of physicians surveyed said the health care system generally provides compassionate care.
When I decided to write about those findings, I was determined to counter them with examples of health care professionals behaving kindly. So I conducted my own little survey of family and friends. To my dismay, every single person I spoke with wanted to tell me about an encounter with a supercilious physician or a cavalier nurse or a dismissive clerical staffer that left them hurt, angry and defensive.
The Health Affairs report was compiled by researchers at the Schwartz Center for Compassionate Care at Massachusetts General Hospital. Kenneth B. Schwartz was diagnosed with lung cancer in 1994. Over the course of his treatment, he was struck by those moments when doctors, nurses or hospital staffers dropped their guards and, in Schwartz's words, "crossed the professional Rubicon" to show their human side. In so doing, they made the horror of his new reality just a little less horrifying. Before he died in 1995, Schwartz founded the center "dedicated to strengthening the relationships between patients and caregivers."
To ensure that all patients receive compassionate care, the Schwartz Center recommends that:
- The federal government include compassionate care measures in national quality standards and create a Compassionate Care Index to measure the level of compassionate care being delivered by health care institutions and individual providers.
- The Patient-Centered Outcomes Research Institute created by the Affordable Care Act fund comparative effectiveness research to determine which aspects of compassionate care have the greatest impact on health outcomes, quality of life and patient satisfaction.
- New health care payment systems, including the Centers for Medicare and Medicaid Services' proposed value-based purchasing system, reward providers for the compassionate care they provide to patients and families.
- Comprehensive training programs be developed to help health care professionals and trainees develop the necessary skills required for compassionate care.
I'm not all that sure that compassion can be effectively measured or mandated, but encouraging it is certainly a good thing. What do you think? Let me know at firstname.lastname@example.org.
Bill Santamour is managing editor of Hospitals & Health Networks. Follow his tweets at www.twitter.com/wsantamour.