How compassion from doctors helps patients heal | Opinion
We knew compassion matters in healthcare. Now we can measure by how much, and how to build it.
There is a compassion crisis in health care. We do not make this statement lightly. This is our conclusion after examining the evidence.
Half of Americans believe health-care providers lack compassion. Research shows that physicians miss most opportunities to respond to patients with compassion. One-third of physicians are so burned out that they have difficulty making personal connections with patients and may be callous or uncaring. Research on electronic health records shows that clinicians spend more time interacting with computers than with patients. If computer screens are substituted for meaningful conversations, clinicians cannot really know patients as people, much less empathize.
But this raises the question: Does compassion really matter? Of course clinicians ought to treat patients with compassion. It is essential to the “art” of medicine. But are there also quantifiable benefits of compassion belonging in the science of medicine?
To answer this, we devoted two years to examining the scientific literature and curating data from hundreds of published research studies. We report the eye-opening results, along with real patient stories, in our book, Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference, and we present select findings here.
Compassion is defined as the emotional response to another’s pain or suffering involving an authentic desire to help. A related term is empathy, which is detecting, feeling, and understanding another’s emotions. Empathy is a necessary precursor to compassion, but compassion goes beyond feeling and understanding as it also involves responsive action. We systematically reviewed the published data to analyze compassion’s effects on health, health care, and health-care providers.
Our aim is not to change people’s hearts. We believe that 99% of people who choose to go into health care have their hearts in the right place. Rather, we curated the scientific evidence to change people’s minds. Medical education often underestimates compassion’s power. When people see all of the data systematically laid out, they can come to understand that compassion is more powerful than they previously realized.
Compassionate care is beneficial for patients across a wide variety of conditions, including the common cold, migraine headaches, chronic back pain, and diabetes. Compassion also improves psychological outcomes, including relief from anxiety, depression, emotional distress from physical illness (for example, cancer), and post-traumatic stress disorder. One of the numerous mechanisms by which compassion improves patients’ health is enhanced patient self-care, e.g., better adherence to prescribed therapy. When health-care providers care deeply about patients, and the patients are aware of this, they are more likely to follow physicians’ advice, including compliance with taking their medicine.
Adherence to therapy not only improves health outcomes, but it also lowers the costs of avoidable disease progression (estimated at $100-290 billion annually in the U.S.). Compassionate patient-centered care is also associated with lower health-care resource use and lower medical bills. Clinicians who do not have strong relationships with patients may be more reliant on costly testing and technology. Clinicians who do not experience satisfaction from treating patients with compassion also take more sick days and medical leaves of absence. Additionally, abundant research shows that physicians who are viewed as less caring by patients are more likely to be sued for malpractice.
Spending on U.S. health care is 18 percent of the Gross Domestic Product and rising. Therefore, we must consider any interventions that can help bend the cost curve — especially those that are low cost to implement. Research shows it takes just 30-60 seconds for a health-care provider to communicate compassion to patients. Simply acknowledging what a patient might be feeling, and being an assuring presence in that moment, can have a meaningful impact.
Further, research indicates that human connection can help combat health care’s burnout epidemic. Compassionate care is a fulfilling experience that builds resilience and resistance to burnout. Thus compassion is good not only for those on the receiving end but also for those who provide it. Neuroscience data support this. Compassion activates “reward” centers in the brain and positive emotions. Those who have close relationships with patients are at lower risk for burnout. Human connection is protective.
After examining hundreds of studies, we see a clear signal in the science: compassion matters — in not only meaningful but also measurable ways. Compassionomics is the convergence of the science and the art of medicine.
In the 2020 election cycle, there will be intense debate about improving U.S. health care and how to pay for it. We raise a consideration that should not be left out of the conversation: compassion is a powerful, evidence-based therapy that is not only effective but essentially cost-free.
Drs. Stephen Trzeciak and Anthony Mazzarelli are coauthors of Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference. Trzeciak is chair of Medicine at Cooper Medical School of Rowan University in Camden, where Mazzarelli is copresident of Cooper University Health Care and associate dean of Clinical Affairs.