Compassion and Medicine

 

Compassion and Medicine
Sara Hylwa-Deufel, MD

As we all know, February is the month dedicated to love. And while we may not always feel love for our jobs, colleagues, patients, or even ourselves, offering compassion is a prerequisite for being a physician. Compassion entails recognizing the suffering of others and being motivated to help. Compassion has both feeling and acting components, distinguishing it from similar feelings like sympathy, empathy, and concern (1).

While compassion is foundational for the physician, little research has been conducted on the subject. However, a recent study from 2022 attempted to address this gap by asking patients what actions physicians take to make them feel cared for. The study found 7 behavioral themes: listening and paying attention (far and beyond the most important behavior in this survey with a whopping 71% of responses), following-up and running tests (11%), continuity and holistic care (8%), respecting preferences (4%), genuine understanding (2%), body language and empathy (2%), and counselling and advocacy (1%). These authors (as well as others) note that while as physicians we may view giving compassionate care as time-consuming, from the patient end, making them feel cared for may only take a moment (1, 2, 3).

So, what is listening and paying attention? It translates to being seen and feeling heard. This can be really hard to do in the busy clinic where multi-tasking is a requirement. We are churning through patients with pagers and phones going off, nurses and staff bringing inquiries, in basket tasks piling up, and more – and all of this is on our minds as we enter into a room and attempt to be wholly present and prepared to connect with a patient on a human level. It’s hard! But giving this compassion is a core part of the job.  

Let’s ask ourselves: what are some other concrete steps we can use to demonstrate compassion to our patients? While body language and empathy were ranked low in this survey, other studies highlight that physician nonverbal behavior / communication and reflective questioning / motivational interviewing shows that empathy does play a significant role in patient satisfaction (4, 5, 6). In my mind, body language and reflective questioning are some of the tools that we as physicians can use to reach the end goal of having patients feel listened to. One of the easiest things we can do is sit down, look patients in the eye, and listen without interruption. These non-verbal communication skills let patients know that what they are saying is important. Then, when they are finished speaking, you can show empathy by asking opening-ended questions. And, do one thing at a time – e.g. document later (if you are able), perform your physical exam after some initial questions as this lets patients know that you are focused (7).

By incorporating these principles into your practice and making a conscious effort to connect with each patient on a human level, you can embody compassion as a physician and make a meaningful difference in the lives of those you serve.

References
1. Baguley S I, et al. More than a feeling? What does compassion in healthcare ‘look like’ to patients? Health Expect. 2022;25(4):1691-1702.
2: Dewar B, Nolan M. Caring about caring: developing a model to implement compassionate relationship centred care in an older people care setting. Int J Nurs Stud. 2013;50(9):1247‐1258.
3: Hemberg J, Wiklund Gustin L. Caring from the heart as belonging—the basis for mediating compassion. Nurs Open. 2020;7(2):660‐668.
4. Chahal K. How your body lanauage affects patient care. Current Psychiatry. 2017;16(7):41-42.
5. Pollak KI, Alexander SC, Tulsky JA, et al. Physician empathy and listening: associations with patient satisfaction and autonomy. J Am Board Fam Med. 2011;24(6):665‐672.
6. Kim SS, Kaplowitz S, Johnston MV. The effects of physician empathy on patient satisfaction and compliance. Eval Health Prof. 2004;27(3):237‐251.
7. Reynolds Keith interviewing Anthony Orsini, DO in How can physicians show more compassion? Medical Economics. November 4, 2019. Accessed: https://www.medicaleconomics.com/view/how-can-physicians-show-patients-more-compassion