Why compassion is important in health care

The consultants had done their analysis and made their recommendation: To provide the best care for patients, Cooper University Health Care should focus on more compassion.

It was 2014. Anthony Mazzarelli, then the chief medical officer, wondered how he’d sell the idea to the staff. He expected eye rolls at what some might consider “mushy stuff.” He decided he needed data. So he enlisted the help of the physician with the reputation of “the science guy” — a.k.a. Stephen Trzeciak, an intensive care specialist at Cooper.

Using a systematic, evidence-based approach, they hoped they would find a few studies quantifying the benefits of compassion. What they found were more than 250 studies, all showing in one form or another that, for patients, compassion matters — not only in meaningful ways, but also in measurable ways.

Perhaps their most striking finding: Compassion can be a powerful beneficial therapy for the giver, too. Among health-care workers, more compassion was associated with more resilience and resistance to burnout. This got them thinking: This couldn’t be true just for health-care workers, could it? Perhaps there is a common thread for everyone, everywhere.

This hypothesis led to their new book, Wonder Drug, where they found — through another exhaustive review of the scientific evidence — that doses of serving others “lead to a long life of health, wellness, happiness, and success” for the one who serves.

Thus, the subtitle: 7 Scientifically Proven Ways That Serving Others Is the Best Medicine for Yourself.

» READ MORE: Finding compassion through fewer words and more presence

Mazzarelli, who is also an emergency room physician, is now copresident and CEO at Cooper and associate dean of clinical affairs for Cooper Medical School of Rowan University. Trzeciak is the chief of medicine at Cooper University Health Care and chair of medicine at the medical school. We spoke to Trzeciak recently.

After nearly 20 years of working in the intensive care unit, and meeting patients and their families on what is often the worst day of their lives, I became keenly aware that I had every symptom of burnout — depersonalization, emotional exhaustion, and a dark feeling that no matter how hard you try, you can’t make a difference. Basically, you feel fried and empty.

One day I had to tell a single mom that her 19-year-old daughter — her only child, best friend, and the center of her universe — was never going to wake up again. On the drive home, I thought the unthinkable: “I don’t know if I can do this anymore.”

But I’m a physician/researcher. So I went to the data. In medical school, we were warned not to care too much. It will burn you out. The advice was that we ought to be distanced, to have an emotional shield.

But the research showed the opposite. The more compassion, the lower the risk of burnout. If you care deeply for patients, you get the fulfilling part of being in medicine. If you don’t have that, all you have is a really stressful job.

So I started to connect more, not less, leaning in rather than detaching. Very quickly, I started doing my job better. I got excited about being a doctor again. And that was when the fog of burnout began to lift.

The preponderance of scientific evidence shows that serving others, even showing simple kindness, is the best medicine for yourself. It is associated with tons of benefits for physical health, mental health, emotional health, and happiness, fulfillment, and well-being, as well as professional success.

One important finding is that those who volunteer to serve others — consistently, not just one and done — have longer lives, on average. And that’s after adjusting for all the other potential confounding factors.

There’s also evidence that having purpose in life — typically, serving something bigger than ourselves in a meaningful way — is associated not only with longer life, but also lower risk of cardiovascular events, lower risk of stroke, lower risk of losing cognitive abilities later in life. It can actually help preserve physical functioning late in life.

As for mental health, serving others — getting out of our own heads — has been clearly associated in many research papers with lower depression symptoms, lower anxiety symptoms, and lower stress and worry.

What the research shows is that helping and serving and kindness for others takes way less time than we think. One bit of research I found is that it takes only 40 seconds of compassion to make a meaningful (and measurable) difference for someone else.

Longer-term, many scientific papers point to a threshold of 100 hours per year for you to experience the benefits yourself. If you do the math, that comes out to 16 minutes a day. We call it your “Daily Sixteen.” You can do it every day or chunk it up on the weekends. Either way, research supports that’s a threshold at which there are benefits for yourself.

Research shows that motives matter. If you’re serving others strategically — giving just to get — it won’t have the same benefits. Brain scans called functional MRIs show that helping others for genuine altruistic reasons triggers a reward center in your brain associated with positive emotions and a slew of other benefits. But when you’re only helping strategically, you don’t get that. Your brain knows the difference — whether you’re doing it for yourself or someone else.

If you know that helping and serving is good for you, OK, that doesn’t ruin the effect. But if that’s the only reason you’re doing it, that’s when it doesn’t work.

The first one, which is key, is to understand that the barrier to entry is small. So start small. You don’t have to quit your job, sell your possessions, move to a Third World country and start hauling water from a distant well. You can start with your Daily Sixteen. And start with the people under your own roof, or in your workplace, those already in your life. Look for those opportunities to give and serve.

Another is what we call the 10/5 rule. If you walk within 10 feet of someone, acknowledge them with a nod or a smile. If you walk within five feet of someone, say something, even if it’s just “hello” or “nice day.” So many times, we are head down, faces in our phone. But research shows that, on average, people have nine opportunities for empathy per day.

Once you start giving and serving, and you get all the feel-good benefits, it’s going to be a virtuous cycle. It is going to keep you wanting to give and serve every day.