The Schwartz Center


‘Schwartz’ Becomes A Verb, Meaning To Care With Compassion

Kenneth B. Schwartz

The Boston-based Schwartz Center for Compassionate Healthcare earns well-deserved praise today on from Dr. Pauline Chen, who writes here:

That professional isolation — and the moral distress that goes with it — has contributed to alarming levels of professional burnout. But one organization has been working to change that by quietly focusing where others have not: on supporting caregivers in their everyday clinical work.

Inspired by the experiences of Kenneth B. Schwartz, a Boston health care lawyer who died of cancer in 1995 at the age of 40, the Schwartz Center for Compassionate Healthcare has for the last 15 years run a program known simply as Schwartz Rounds. Held on a monthly or bimonthly basis in hospitals, nursing homes, community health centers and academic medical centers across the country, these rounds, or meetings, are an opportunity for clinicians to discuss emotionally challenging cases or issues in their work.

The story goes on to describe the benefits of such sessions, from re-energized medical staffs to improved communication. We’ve written about the Schwartz Center’s work before, including Rachel’s recent post about the “compassion gap” in medicine and this video of Massachusetts first lady Diane Patricks discussion of her depression. Here’s my favorite part of today’s story:

The change even trickles down to the language of the workplace. “At some centers, ‘Schwartz’ has become a verb,” said Julie Rosen, executive director of the Schwartz Center. “To ‘de-Schwartz’ means to lose one’s compassion, and to ‘Schwartz it’ means to add conviction and compassion to a job.”

Readers, have you ever participated in a Schwartz Round? How did it affect you?

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.

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Compassionate Care: The Difference Between Life and Death

Kenneth B. Schwartz

The Schwartz Center for Compassionate Health Care at Massachusetts General Hospital is named after a former health care lawyer, Ken Schwartz, who, at age 40, was diagnosed with advanced lung cancer. While undergoing the usual harrowing ordeal of treatment — chemo, radiation, surgery, and bad news layered upon more bad news — he wrote a piece for The Boston Globe Magazine about his care at MGH.

Facing near-certain death, Schwartz wrote that his “ordeal has been punctuated by moments of exquisite compassion. I have been the recipient of an extraordinary array of human and humane responses to my plight. These acts of kindness — the simple touch from my caregivers — have made the unbearable bearable.” He died in September 1995, about 10 months after his diagnosis.

These days, The Schwartz Center sponsors projects ranging from medical education and scientific research to dispersing grants, all to promote the practice of compassionate care in medicine. This week, they released a new national survey of doctors and patients. The most surprising finding is this:

When asked whether “good communication” and “emotional support” can make a difference in whether a patient lives or dies, 81 percent of patients said: Yes. But what’s really shocking, is that 71 percent of doctors also agreed. That means that the vast majority of patients and doctors believe that compassionate care, defined as an emotionally supportive provider who actually talks and listens to his or her patients, can mean the difference between life and death.

Beth Lown, medical director for The Schwartz Center, and an internist at Mt. Auburn Hospital in Cambridge, helped devise the latest survey, which includes 800 patients and 500 doctors. She said she believes scientific advances in medicine, and cutting-edge technologies and treatments have largely “superceded” low-tech care that includes dialogue, communication and trust. “There’s such a high priority put on medical intervention — and to a large extent technical skill is valued above interpersonal, relational skill — that I was surprised to see the extent to which everyone agrees that communication and emotional support makes this kind of difference,” she said. Continue reading