Compassionomics

[jmj11]

Has anyone read this book? I just heard a review this morning and it sounds very interesting. Spending more time as a patient than a provider these days, I am disappointed at the basic level of compassion within our system. Compassion means things like knowing the patient's name, knowing their diagnosis and medical history before going into the room. Those simple things that I had always took as granted as what I should do.

 

https://www.amazon.com/Compassionomics-Revolutionary-Scientific-Evidence-Difference/dp/1622181069/ref=sr_1_1?crid=130FY276ZGZCD&keywords=compassionomics&qid=1556408042&s=books&sprefix=compassion%2Ctoys-and-games%2C217&sr=1-1

[ventana]

have not seen this book but as I help a family member through the final months I am struck by the medical knowledge is not the thing we value (as patients) but instead someone that knows us, listens, and is compassionate...... 

[thinkertdm]

That's just crazy talk.  Knowing things like basic medical history and even patient names takes time, and any time not billed for is wasted.  Especially when you can review the history as they are talking, and no one cares about names when I may or may not seem them again because they may see another provider in the clinic.

I'm not joking either; an admin once walked through a clinic measuring rooms; any rooms not used by providers seeing patients was lost revenue.

I am dead serious.  Medicine is a retail service, not merely existing to support itself, but attempting to profit.

Now, as a patient, what I want is not reflected in the after visit questionnaires.  I want someone who comes in at a time of my most vulnerable, scared, terrified time and to tell me it's going to be ok; they are here to help.  And I want to believe them.

Both of those are lacking in every clinic I've worked, or been a patient, in.  What I get is led into a cold smelly room, asked questions by an LPN with basic science knowledge and even less science skills; then I wait; the provider breezes in, barely acknowledges me, asks some questions, prescribes something, and I walk myself out.  I usually get lost.

My wife was at an appointment and the provider never looked at her- literally never moved her eyes off the computer.  She could have been on fire and the provider never would have noticed.

This half the fault of the providers, who allowed it to happen, and retail industry, in the drive to package and sell the most human of professions.

[TWR]

Reminds me of a 1991 movie called "The Doctor".  I watched it with great interest then and think of it often today.  Kind of a wake up call or slap in the face.  Should be required watching the last semester of PA school.  Starred John Hurt as an egotistical cardiologist who gets diagnosed with cancer.

[sk732]

3 hours ago, TWR said:

Reminds me of a 1991 movie called "The Doctor".  I watched it with great interest then and think of it often today.  Kind of a wake up call or slap in the face.  Should be required watching the last semester of PA school.  Starred John Hurt as an egotistical cardiologist who gets diagnosed with cancer.

I remember that movie...it's autobiographical IIRC.  The end was perfect with all the medical students being on the wrong end of something not pleasant - enemas, catheters, etc.

This book sounds a bit like Brian Goldman's book that came out last fall "The Power of Kindness", which is about empathy.  For those not familiar with Dr Goldman, he's an ER doc and talk show host, as well as author and speaker.  https://www.harpercollins.ca/9781443451062/the-power-of-kindness/

 

SK

[CAdamsPAC]

 

 

 

19 hours ago, jmj11 said:

Has anyone read this book? I just heard a review this morning and it sounds very interesting. Spending more time as a patient than a provider these days, I am disappointed at the basic level of compassion within our system. Compassion means things like knowing the patient's name, knowing their diagnosis and medical history before going into the room. Those simple things that I had always took as granted as what I should do.

 

https://www.amazon.com/Compassionomics-Revolutionary-Scientific-Evidence-Difference/dp/1622181069/ref=sr_1_1?crid=130FY276ZGZCD&keywords=compassionomics&qid=1556408042&s=books&sprefix=compassion%2Ctoys-and-games%2C217&sr=1-1

I was in the cardiac cath lab as a patient a couple of months ago as the last patient of the day add-on, the physician didn't know my name or medical Hx the nurses seemed rushed to get out, so I declined to have him do my procedure. I waited until the physician who actually knew me was available to perform the cath. I say if providers treated their patients like they want their mother cared for there would be no issues.

[SedRate]

This is the reason I'm currently applying for a new job. Patients have become numbers. I got into medicine to help people and to try to give them the answers they seek, but I can't do that when the surgeons are getting greedier and companies are run by non-medical business people.

[mgriffiths]

On 4/28/2019 at 7:15 AM, TWR said:

Reminds me of a 1991 movie called "The Doctor".  I watched it with great interest then and think of it often today.  Kind of a wake up call or slap in the face.  Should be required watching the last semester of PA school.  Starred John Hurt as an egotistical cardiologist who gets diagnosed with cancer.

I believe the actor was William Hurt, but otherwise spot on...we actually watched while in PA school and then discussed during our class as part of a medical ethics course.

[sas5814]

22 minutes ago, mgriffiths said:

I believe the actor was William Hurt, but otherwise spot on...we actually watched while in PA school and then discussed during our class as part of a medical ethics course.

It was and it was a good movie if not a bit hokey sometimes.

One of my UC colleagues was recently hospitalized in our system and the care she received was horrible. impersonal, rushed. She even caught 2 different ICU hospitalists documenting visits that never occurred. She was in the ICU for almost 48 hours before she was actually seen by a physician but there were multiple visits charted. I have encouraged her to have conversation with the powers that be and she is.

I find empathy burnout or exhaustion to be my biggest problem. We have become the WalMart of health care and after a while people are just problems I have to deal with.

[MediMike]

I'll tell you what...as a healthy 36yo male who was a gypsy for most of his adult life I haven't had an established PCP since I was a child. My wife hammered at me and convinced me to go, got me a "new patient" 30 minute appointment with the provider down the street. 

I'll admit, I was pretty excited to build a rapport with someone as I had watched the doc I was with in my rural FP rotation do, to talk about my health concerns, my family etc 

I was, no $!&# in and out in under 5 minutes, no eye contact and a cursory listen to my heart and lungs. Not even a good listen either. I spend more time talking to my gorked/intubated/sedated folks. Was pretty upset, almost enough to make me want to see the NP in the office. 

I think it is incredibly important to at least be able to fake those things mentioned above, and I don't care how busy you are, you can take part of the remaining 25mins that you are billing for my appointment to ask what I do for a living, or where I grew up, or how old my kid is. 

Obnoxious.

Ok. Rant over .

[thinkertdm]

I saw a neurosurgery resident at Walter reed with a patient who had a broken back and was paralyzed; he had just been transferred from someplace.  This resident, to take the history, held this kids hand and leaned in so the patient could see him.  I imagine he had seen a lot of ceilings on his way over.  The resident took his hand, looked him in the eyes, and calmly said "hi ###, I'm Dr **, and we are going to take care of you".

Don't really have a point to this story except that we can still show compassion without being a jerk.  

[ohiovolffemtp]

This thread highlights the tension we all feel between the desire to provide good patient oriented care and the push from above to see patients faster.  I feel that I can work on how well I interact with patients and their families within the limited time available, but not extend the time I spend with them.  This was a big issue in a busy L3 trauma center, fortunately much less so in the rural critical access hospital where I work now.

I'm reminded of the quote, "the most important thing in dealing with people is sincerity, and when you learn to fake it you've go it made".

[BruceBanner]

The commercialized system we practice in takes every possible measure to make it hard for you to be compassionate, yet still demands that you do so. Inasmuch as it effects their bottom line anyways.

It's a sad irony. It reminds me of this recent video ZDogg did on burnout, which he calls moral injury.

 

[mgriffiths]

6 hours ago, MediMike said:

I'll tell you what...as a healthy 36yo male who was a gypsy for most of his adult life I haven't had an established PCP since I was a child. My wife hammered at me and convinced me to go, got me a "new patient" 30 minute appointment with the provider down the street. 

I'll admit, I was pretty excited to build a rapport with someone as I had watched the doc I was with in my rural FP rotation do, to talk about my health concerns, my family etc 

I was, no $!&# in and out in under 5 minutes, no eye contact and a cursory listen to my heart and lungs. Not even a good listen either. I spend more time talking to my gorked/intubated/sedated folks. Was pretty upset, almost enough to make me want to see the NP in the office. 

I think it is incredibly important to at least be able to fake those things mentioned above, and I don't care how busy you are, you can take part of the remaining 25mins that you are billing for my appointment to ask what I do for a living, or where I grew up, or how old my kid is. 

Obnoxious.

Ok. Rant over .

As a healthy 29yo male, your story is pretty close to why I haven't had an exam in probably 5 years.   I was going to last year and at the visit request blood work just to see what my cholesterol and so forth are since I am "obese" at BMI = ~31.  Ended up getting the labwork when setting up my life insurance so never had the exam - labwork was normal, just wish my HDL was higher...

Bottom line, the only provider in the area I live that I know that I would like to see is the doc I worth with...but honestly I don't want him knowing my medical history, and he has a GOOD policy against seeing coworkers (including support staff like MAs, front desk, etc.).

Weird and sad to be part of a system like this...and I don't mean my employer, I mean healthcare in general.