It’s no secret that I am a big fan of Rana Awdish, MD, FCCP at Ford Medical Center in Detroit. Dr. Awdish is also the author of In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope, the first-hand account of a physician who suddenly becomes a dying patient. In short, she experienced both sides of a white lab coat.
I first met Dr. Awdish in a small conference room with other doctors and nurses and a bioethicist thrown in for good measure. I was there to explain the benefits of using the immediacy and intimacy of theatre to build compassion and reduce burnout. I described the various short plays within the Grief Dialogues library to the folx in the room.
With little explanation needed, the group loved the idea of bringing a new method of learning to their fellow health care providers, one that would promote the evidence-based concept that compassion is good for the physician and good for the bottom-line.
The excitement of working with Dr. Awdish grew when I read her book and wondered aloud if it would make a good play. And it was her experience with compassion while nearly losing it all that held my attention.
No one I know goes into medicine focusing solely on bottom line results. They firmly believe in Do No Harm. And yet, health care providers are constantly barraged with organizational pressure, moral choices, societal expectations, and even their own standard of care that is sometimes higher than the organization’s.
Unfortunately, in stressful situations our compassion goes out the window.
Here’s a recent example, Dr. Mehmet Oz, recently spoke freely about the necessary loss of life in order to revive the economy (bottom-line focus) after the COVID-19 shutdown.
I just saw a nice piece in The Lancet arguing that the opening of schools may only cost us 2 to 3 percent in terms of total mortality.
A “nice piece” -- only cost us 2 to 3 percent! Those numbers may relate to “mortality” but what happened to “morality.” What happened to compassion? Is compassion lacking because there are no faces attached to those numbers? Or is there simply no time to think…especially in a crisis?
As a patient I know when I am regarded with judgement the first time I meet a health care provider. When asked “how are you feeling?” I immediately respond “I’m doing great” even though I sought medical care for serious pain or a high fever. But they aren’t really listening. They don’t comment on the ironic fact that if I was doing great I wouldn’t have come to the doctor’s office, and so the judgment, on both our parts, begins.
Is it my job as the patient to put the doctor at ease or is it the other way around? If I wasn’t so ill or injured, I’d walk out of the room.
As Dr. Awdish writes in her book In Shock.
Physicians often enter the lives of patients on their absolute worst days.
And so it goes. The health care provider walks confidently into the room. I may be the first patient he’s seen today. Or maybe I’m the last. No matter. I can only hope that the provider realizes he is walking into the middle of my life.
He give orders and expects me and my loved ones to follow them. The doctor asks sensitive questions expecting truth in reply and will immediately prioritize health as my top value amongst all my deeply held values that I hold dear. All in the name of providing me quality health care.
They are in a hurry. There’s no time for compassion especially while treating the flood of new patients entering the hospital with COVID-19. And yet it seems to be more vital than ever to put compassion at the forefront of health care.
It’s not that I don’t understand the strain currently on our medical providers. Much like Dr. Awdish, it’s because I DO understand. What I don’t understand is why we allow the U.S. health care system to fall short? I believe we can do better.
Does it really come down to this one simple and vital component: Compassion? It’s a FACT: Without compassion the provider experiences poor patient outcomes and public perceptions.
Recent evidence shows it only takes 40 seconds of compassion patient care to significantly improve their health.
So what is Compassion?
The definition of compassion, according to the Merriam-Webster Dictionary, is the “sympathetic consciousness of others’ distress together with a desire to alleviate it.”
With a desire to alleviate it! Isn’t that exactly what a medical provider expects to do? Isn’t that what the patient WANTS the provider to do?
I know. No time. Yet there is dramatic evidence that patients NEED compassionate care.
A year ago, health technology company HealthTap released a report showing that when ranking doctors, compassion is more important to patients than cost or wait time. Yes, it’s true.
In the survey, 85% of patients reported compassion is very important to them when making a decision about health care, while only 31% said the same about cost and 48% said the same of wait times.” according to Health Care Business Technology.
I needed additional evidence, and in February 2020 when Grief Dialogues sponsored a day-long seminar with the Live Well Die Well Tour in Los Angeles I found it. After a performance of three plays from the Grief Dialogues Library, one of the participants approached me. “Have you heard of the book Compassionomics? It just came out.”
Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference by Drs. Stephen Trzeciak and Anthony Mazzarelli created for me more than one AHA! moment. This one by Anthony Mazzarelli, M.D., Annals of Internal Medicine, April 4, 2017 jumped out at me:
Patients and families may not remember your name or your face, but they will never forget the smallest comforts you offered in those moments because they will never forget the memory of what they were feeling.
A pandemic might not be the best time to try something new. Then again it’s not the worst time either. In upcoming blog posts, I will share some suggestions on how to immediately add compassion to your daily routine.
In the meantime, I do want to recognize those exercising extreme compassion during this dark time.
- To the doctors who put pictures of themselves on their name tags so that the patient knows who is under all the protective gear. Thank you.
- To the nurses who asked for extra shifts and those who work as their patients communication center. Thank you. [For more stories of nurses on the front lines, check out HCA Healthcare.]
- To all essential health care workers: janitors, food service personnel, schedulers, Med Techs. Thank you.
- To all COVID-19 doctors. THANK YOU. Just weeks ago, there was no such thing as a COVID doctor. I know some feel unprepared and afraid. But you have risen to the occasion. You’ve trained your whole life for this moment. I am confident you will conquer your fear, learn new skills, and I know you will learn them fast.
- To Dr. Rana Awdish, and all medical providers like her, thank you for sounding the bell for compassion in health care years ago. Perhaps now is a good time to revisit the need.
P.S. I knew that I would like Compassionomics the moment I opened the front cover.
References
Drs. Trzeciak an Mazzarlli conclusively demonstrate that the power of compassion in medicine is undeniable. Well-researched and comprehensive, the book will be a valuable tool for anyone with a desire to reestablish the primacy of compassion in health care. ~
Rana Awdish, MD, FCCP, author of In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope
