Are doctors and patients on the same side? Are patients completely honest and cooperative, because they perceive the doctor as primarily caring about their situation, and is a doctor’s attention actually focused mainly on the patient as a human being who needs help? These days, it seems that either side can have doubts about the other, and this is not only leading to a lowering of trust and empathy in general, but also creating what some are calling a “compassion crisis” in healthcare.
I have been working with Better for several years as a kind of language consultant. This has meant working with their teams to research and practise effective ways of improving their English communication skills for projects with international partners and projects, and also working with their writers to maintain a high level of clarity for the texts they publish for various websites, blogs, and press releases.
Even though they long ago reached a level which many would consider “good enough” for an international company in this field, they have stayed committed to improving in all areas. As a result of their commitment, I have also been motivated to read about what is happening in their field. As a result, I have not only found material for our classes and workshops, but I have also received some insight into their work and the field of medical IT.
Recently, I came across an interesting podcast from Freakonomics titled: How Do You Cure a Compassion Crisis? (Ep. 444). I was surprised that this episode focused entirely on healthcare and some of the problems being faced due to a lack of compassion, and I immediately saw that the topic was directly connected to the work that Better is doing. The idea of digitalising the healthcare process to reduce medication errors and improve the workflows of health and care teams (who are often struggling with burnout), but also to facilitate more patient-centred care have been priorities at Better for years.
My impression of healthcare before working with a company in the actual field was like that of many people. I had the impression that politics and bureaucracy were overcomplicating things and devouring budgets with an “efficient form of inefficiency”, and I was often told that healthcare workers were becoming increasingly jaded and cynical because of unrealistic workloads and patients who just wasted their time. My own experiences had been positive, but there seemed to be no end to the negative stories.
After working with Better, I started to see how both the patients and healthcare professionals could be victims of inefficiency, and the Freakonomics podcast really drove the idea home: the compassion crisis in healthcare goes both ways. The level of compassion which doctors have goes down with burnout, but the level of compassion which patients have for their doctors and the entire healthcare system also goes down when they feel like they are just a number, or item on an assembly line. They both affect each other, and this creates a vicious circle, as all this negativity can also worsen health outcomes. For example, if patients don’t like or trust their healthcare providers, they are not as honest when giving information, and don’t tend to follow medical instructions as carefully.
One of the factors affecting the way medical professionals do their work is the quality of their tools, and some of the electronic “solutions” currently on the market have created more administrative work for doctors than before, which leads to more burnout, and even less compassion. According to the podcast, Helen Riess, a Harvard psychiatrist who also practices at Massachusetts General Hospital, estimated that the current empathy level of an American doctor was about 4.5 out of 10.
It is not just the amount of work that bothers doctors, but the limited amount of contact they have with patients. Riess speaks with medical students often, and constantly hears things like, “When I chose this as a profession, I thought I’d be spending most of the time with patients.” The sad reality is that the average resident spends about 12 minutes a day with their patient – and the rest inputting information into a computer. Atul Gawande, a prominent American physician, surgeon, public-health researcher, and best-selling author, said it felt like being a “glorified data-entry clerk”.
Therefore, many hospital administrators, doctors, and health-care personnel are sceptical about IT health solutions, and feel that computers and modern electronic health records (EHRs) are making things worse. In fact, in a recent February 2021 newsletter from Better, two such sources were mentioned:
- To Combat Physician Burnout and Improve Care, Fix the Electronic Health Record by Robert Wachter and Jeff Goldsmith, which connects the amount of time needed for data entry with burnout – but also mentions some of the terrible and out-of-date user interfaces, and suggests more patient-centred care structures.
- How Doctors Feel About Electronic Health Records, a National Physician Poll by The Harris Poll, which sees a connection between some EHR systems and physician burnout, blames interfaces for not being intuitive enough, and suggests interoperability and future data availability as a priority for future development.
It is true that much of the documentation in a hospital has been (and is still being) digitised, meaning that it is being transformed into a digital format, but this is mainly related to the digital storage and retrieval of information, and this seems to be the source of many headaches in the reports I mentioned above. However, digitisation is just the first step...
Patients come to a hospital expecting two things: to receive treatment, and to be treated like a person – especially when they are in a vulnerable state. These two areas are linked. As mentioned above, patients who like and trust their doctors have better outcomes, and follow instructions more closely. It is also a big deal for another reason. Several studies, according to the podcast, have also linked such compassion or empathy from patients to lower levels of burnout with medical professionals. Basically, compassion can also “heal the healers”, or as doctors and authors and authors Trzeciak and Mazzarelli put it: “Compassion — the thing that doctors need to show — is the very thing that doctors need.”
If you are interested in the details, check out the podcast. Better has clearly identified a specific issue within an extremely complex system, and is using technology to create a human solution. This is not only about helping people by giving them professional medical attention and reducing wasted time and errors, but also getting all of those involved – doctors, nurses, other care professionals and patients – back on the same team.