Managing the Compassion Crisis

“We’re in the midst of a compassion crisis.”

Less than a minute into the opening keynote, delivered during last week’s New Jersey and Delaware Valley HIMSS fall conference, I was hooked. I knew right away there would be no texting, no fidgeting, and no adding to my ever-growing shopping list. Steven Trzeciak, MD, Chief of Medicine at Cooper University Health Care, had captured the attention of everyone in attendance, including myself.

Trzeciak, a practicing intensivist and physician scientist, is focused on a new field called “Compassionomics” which studies the scientific effects of compassion on patients, on providers, and on the care itself. If it sounds like a bizarre hybrid buzzword to you, you’re not alone. But what compassionomics lacks in style (or perhaps more accurately, pronouncability), it makes up for in substance.

Consider the following points from Dr. Trzeciak’s presentation:

• A correlation has been established between compassion and care quality. Physicians who are able to connect with patients are more likely to become invested and provide a higher level of care.
• When providers make the effort to “know the patient as a person,” patients have a 33 percent higher chance of adhering to treatment plans. This is extremely significant; nonadherence costs billions of dollars each year, and takes “an enormous human toll” on patients and caregivers.
• Studies have shown that a physical human connection can reduce an individual’s perception of pain, and can help regulate immune function.
• In some cases, compassion can even help reduce the need for pain medication following surgery.

A pretty compelling case, if you ask me.

On the other hand, depersonalization — or a lack of empathy — can lead to higher error rates and decreased care quality.

 

According to research funded by the National Institutes of Health, providers miss as many as 60 to 90 percent of opportunities to demonstrate compassion. When this happens, “they’re missing the emotional cues that can be vital in making a diagnosis,” noted Dr. Trzeciak. Cues they could easily pick up if they take the time to make a real connection.

The problem, he pointed out, is that the last thing physicians seem to have is time. The amount of documentation required during already brief encounters leaves little room for establishing a rapport, let alone building the trust needed to determine an agreed-upon treatment plan. Between technological challenges, changing regulations, and ever-increasing workloads, physicians are frustrated, exhausted, and in some cases, depressed. They’re hardly in the right state of mind to look a patient in the eyes, observe what’s being expressed, and assure them that “we’re in this together.”

It’s a struggle Dr. Trzeciak knows well, having experienced burnout several years ago — long before the concept was understood, or even acknowledged. As a matter of fact, the advice he received after approaching leaders with his concerns was to take some time off. Although he has always been an advocate for maintaining a healthy work-life balance, to Dr. Trzeciak, the idea of escaping — of separating from patients — didn’t seem right.

The solution, he discovered after some experimentation, was to get closer to patients, rather than detaching. And while it certainly didn’t save time (especially in the beginning, when it wasn’t yet part of his workflow), he found that forming real connections with patients and caregivers paid enormous dividends in the long run. Once patients realized how invested he was, they bought in as well.

Compassion, however, has taken a back seat, which Dr. Trzeciak believes is a “public health problem,” he said. “It’s also a fixable problem,” provided physician leaders are willing to work together to address the root issues, and IT leaders are willing to focus less on the technology piece, and more on the human aspect. “IT has an opportunity to make an impact.”

And perhaps, put an end to the crisis.