compassionate care


Mass. General ‘Be Nice’ Video Meant For Staff But Useful For Patients


“Is this begging for parody or what?” I thought. Massachusetts General Hospital paid its employees $250 each to watch a video reminding them to be nice to patients?!

That was my first reaction upon reading this scrupulously deadpan Boston Globe story headlined “Mass. General employees watch customer service video — for $250.” It carefully notes that the $250 incentive brought complaints from some competitors at a time of tight health care dollars, but also that such pay is “an approach common in other industries and that proved to be an overwhelming success for the hospital.”

(Dear Boston Globe: At times like this, I can’t help hoping that you’ll be bought by The Onion or The Daily Show. Can’t you have even a little fun with news that makes people go “Huh?”)

So how could one best bowdlerize the earnest, mission-driven video above featuring Mass. General chief Dr. Peter Slavin? One idea: You could provide translations to plainer speech. For example:

Massachusetts General Hospital president Peter L. Slavin

Massachusetts General Hospital president Peter L. Slavin (MGH)

Slavin: “It’s also important that we speak well of each other and of other departments when interacting with patients and their loved ones, to help them feel assured of our teamwork in caring for them.”

Translation: When your colleagues are jerks, do not scare patients by telling them about it.

Slavin: “There is no doubt that even long-time patients and their families can often be nervous and uncomfortable when coming to the hospital or visiting their doctor or other clinician. How we first greet them often sets the tone for a successful positive admission or visit.”

Translation: Most people walking into our halls are scared out of their wits. Have a heart.

Readers, other translations welcome. But in truth, I come away from watching the 11-minute video with the sense that though it was meant for the hospital’s 22,000 staffers, it is an excellent tutorial for every one of us as potential patients. Continue reading

‘Everyone Needs A Caring Listener’: Gut Doctor Wins Compassion Prize

Dr. John Zawacki (Courtesy of The Schwartz Center)

Dr. John Zawacki grew up on the grounds of Taunton State Hospital, the huge psychiatric hospital now so old the state is in the process of closing it. As a child, he would say good night to the mentally ill patients waiting in the hallway outside his psychiatrist-father’s home office on his way to bed. He recalls:

“When I asked Dad why people needed a psychiatrist, he said: ‘John, everyone needs a caring listener sometime in their lives.” When young John expressed interest in becoming a doctor, his father had him spend the summer in the psychiatric hospital’s back wards, cleaning up incontinent male patients. The point: “There is no job which is beneath you.”

John went on to become a gastroenterologist and a professor of medicine at UMass Medical School, treating patients with tough disorders like Crohn’s, colitis and inflammatory bowel disease. And he must have treated them with extraordinary kindness, because he has just won the annual Schwartz Center Compassionate Caregiver Award. Check out last year’s winner, a hospice worker, here, and here’s an inspiring Schwartz Center video of this year’s five finalists, two nurses and three doctors.

Here are excerpts from Dr. Zawacki’s remarks last night at the Schwartz Center dinner: Continue reading

Where’s The Love? Study Details Health Care Compassion-Gap

About half of patients (and many doctors) say there is something simple, but critical, missing from health care in the U.S. these days: Compassion.

In a new paper published in the September issue of the journal Health Affairs, researchers from The Schwartz Center for Compassionate Healthcare report on a deep compassion-gap in the system, and offer some suggestions on how to fix it:

Our survey of 800 recently hospitalized patients and 510 physicians found broad agreement that compassionate care is “very important” to successful medical treatment. However, only 53 percent of patients and 58 percent of physicians said that the health care system generally provides compassionate care. Given strong evidence that such care improves health outcomes and patients’ care experiences, we recommend that national quality standards include measures of compassionate care; that such care be a priority for comparative effectiveness research to determine which aspects have the most influence on patients’ care experiences, health outcomes, and perceptions of health-related quality of life; and that payers reward the provision of such care. We also recommend the development of systematic approaches to help health care professionals improve the skills required for compassionate care.

Continue reading

Bedside Manner At Harvard Med School: You Can Touch The Patient Now

Boston science journalist Madeline Drexler recently found herself in a unique position: she was a “practice” patient for a group of second year students at Harvard Medical School, who gathered to listen to her unique “clicking” heart murmur.

The students learned about Drexler’s unusual heart, and she learned something too: certain physicians are so humane and compassionate it can actually be therapeutic, while others just stress you out even more.

In a piece for The New York Times today, Drexler writes about the power of connection between doctors and patients, the value of listening and the good that can happen when a physician learns to evaluate a whole person, not just run down the data points of a disease.

What else did Drexler learn? Well, according to her Massachusetts General Hospital doctor, Diane Fingold, who is, by the way, helping to rewrite the Harvard Medical School curriculum, touching patients is something that medical students must work up to:

At Harvard, she explained, students don’t touch patients until the second year; some schools even delay that fundamental skill until the third. Now a move is afoot to make this happen right away, in the first year, so the connection quickly becomes natural and ingrained. Blending the mechanics of the physical exam with meaningful conversation is what Dr. Fingold calls “the unwritten curriculum.”

But apparently compassionate care can still be taught in school — at least a little. Here, Drexler, who is also editor of the Harvard Public Health Review and a Senior Fellow at Brandeis University’s Schuster Institute for Investigative Journalism, reports to her doctor about the tremendous differences among the med students who listened to her heart:

I told her I had seen stark differences among the students. Some, like Ben, seemed to be born doctors. Others appeared to have no grasp of human connection.

“We used to assume,” she said, “that people who went to medical school were all compassionate, were all good listeners — that we just needed to give them the knowledge and they would be good doctors. We now know that’s not the case.

“But we don’t give up on the ones who don’t have it from the beginning. We can give feedback that helps. It won’t make a stiff lab-rat type into a palliative-care oncologist. But it can make a difference.”

Dr. Treadway quietly leaned in the doorway, listening to our conversation. After a few minutes, she said: “There are some doctors who do not view you as a patient. They view you as someone with a heart murmur who they’re going to listen to.”