The empathy enhancementby Ruth Nichol
Patients with doctors who attend to their emotional needs get well faster.
Robin Youngson broke one of medicine’s unwritten rules a few weeks ago. He held a patient’s hand and cried with her – a show of emotion most doctors consider unprofessional.
For a large part of his 29-year medical career, Youngson would have considered it unprofessional too. His default position when dealing with patients – even one about to have a caesarean section to deliver a baby who had already died – was one of clinical detachment.
Like many of his colleagues, the Raglan-based anaesthetist would provide his patients with jargon-laden technical information, but he was less likely to engage with them on a human level, let alone acknowledge the emotional toll their suffering sometimes took on him.
“It’s completely taboo for a senior doctor to talk about his or her feelings.”
But all that changed 12 years ago when one of his daughters had a serious car accident and spent three months in hospital – the same hospital where Youngson was once a member of the executive management team.
Experiencing the health system from the other side was eye-opening. Although none of the staff who cared for his daughter were actively unkind, nor were they encouraged to attend to her emotional needs. Instead, they were expected to focus on such tasks as administering medication and filling in paper work.
“It kind of radicalised me,” says Youngson. “Technically the quality of care was excellent and my daughter made a full recovery physically. But the way the medical system treats its patients is just callous. It’s completely indifferent to human suffering, and sees the human body as a broken machine that needs to be fixed.”
He says the way modern hospitals are run isn’t just bad for patients, but bad for staff too – particularly young doctors and nurses who, unlike their counterparts in organisations such as the police, get little support to help them deal with often deeply distressing experiences.
“You need to be able to acknowledge that they have feelings, and take them by the hand to accept those feelings and talk them through.”
In 2006 Youngson set up the Compassion in Healthcare Trust (now Hearts in Healthcare), an organisation committed to “rehumanising” healthcare. He now works part-time as a locum anaesthetist, spending the rest of his time travelling around the world promoting the importance of compassion and empathy in medicine at workshops and presentations. “For me it’s a grand obsession – I’ll admit that.”
It’s an obsession with sound scientific backing. Studies dating back to the 1960s have found that patients with empathetic doctors get well faster and are less likely to experience complications. A 2012 study involving 21,000 Italians with diabetes, for example, found that those with empathetic GPs were 41% less likely to be admitted to hospital with life-threatening complications.
“We don’t have any quality improvement projects that can improve acute hospital admissions in that way.”
Even small amounts of empathy can go a long way. A 1995 Canadian study found that getting trained volunteers to talk for just 30 minutes to homeless people who turned up at the emergency department of a large city hospital reduced their likelihood of returning there by a third.
Youngson points out that for doctors, compassion and empathy are about more than holding a patient’s hand and weeping with them. In the case of the woman whose baby had died, for example, he also devised an anaesthetic plan that meant she would be unconscious during the delivery but alert and pain-free afterwards so she could hold – and start grieving for – her baby.
“Obviously doctors can’t afford to be overwhelmed by emotion, especially when they are dealing with a medical crisis. But they also need to be able to turn off their technical minds and turn on their empathy and compassion.”
It’s a big ask, and Youngson is not sure that existing medical institutions are capable of becoming truly compassionate.
On the other hand, he is encouraged by the fact that Hearts in Healthcare has motivated thousands of healthcare professionals both here and overseas, to change the way they work.
“They have made an individual choice to be a bit courageous and bend the rules and act in a way that might be deemed unprofessional.”
Read more at heartsinhealthcare.com
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