Bertalan Meskó, MD, PhD

Director of The Medical Futurist Institute(Keynote Speaker, Author & Futurist) . 302 articles

While modern medicine created the professional, efficient, metric-driven medic alienated from the patients, the need for compassionate care is more urgent than ever. However, that’s not only up to the physician but also the organization, because individual attempts might result in burnout symptoms. Adoption of A.I. could change the situation for the better in the future, as it would create space for doctors and nurses to spend more quality time with patients. The question is, are doctors ready for it?

Compassionate care is paying attention to the needs of the others, listening to spoken or noticing unspoken wishes, imagining the other person’s situation and expressing acts of empathy to lessen suffering, pain or distress. If you need to feed a plush armadillo with candies and invent a bedhead board for a toy animal to make a patient feel better, than that’s compassionate care, but it could also be the right tone of voice, a simple touch, a loving glance or just sitting on the bed for a while to provide some company. As nurse and speaker, Joyce Hyam, penned it, when you give compassion it will always be remembered. When you receive it, you will always hold that memory in your heart. You can make a difference in someone’s life. Compassionate care is a crucial component of care. So, how come that it’s missing so much from healthcare these days?

The scale from dispassionate healers to mother surrogates

Doctors, nurses and other medical professionals genuinely possess the traits of empathy, compassion and the intention to help others – otherwise, they wouldn’t have chosen medicine and care as their profession. However, as they progress through medical school, stress, anxiety, competitiveness and lack of time often start to erode their levels of compassion.

The same will continue on their professional journey: the patient will “get lost” in the ocean of CT scans, biopsies, charts, diagnoses, and administrative tasks. The doctor hides behind a pile of papers, badly designed IT interfaces, curses the monitor and alienates himself from the people in need. The phenomenon is quite understandable: expressing compassion and carrying the emotional burden together with patients is tough, energy-sucking and the environment gives no time for processing it. It is “easier” to handle 15 patients a day being shut down, otherwise, the risk of burnout gets higher. Also, the doctor’s figure is usually cemented as someone with authority and respect with less inclination to show signs of empathy and emotion in general.

That’s entirely the reverse in the case of the nurse. Since the era of Florence Nightingale, the founder of modern nursing, the profession was associated with an idea of doing God’s work through attending to those in need – which came into more and more contrast with the efficient, professional, “dispassionate healer”. Nurses are regarded as the ones who will provide attention, deliver words of kindness and hold their hands when patients are in agony.

The growing dichotomy between the need for the “surrogate parent” sitting at the bedside of patients and the performance-seeking medical professional is at the core of present-day calls for more compassionate care. Why is that so?

Calling for more compassionate care

In the the last decades, medicine and healthcare were so focused on training “metrics-driven”, efficient elements in the systemic machine of healing patients reduced to numbers on papers and later in EHRs, that the “surrogate parent” was pushed completely to the background. No wonder – it’s expensive, but no one wants to pay for the costs of compassionate care. First, staff may have to engage in emotionally charged interactions, which can leave them feeling psychologically exhausted and at risk of burnout.

Second, for health professionals to be able to connect with patients and understand their unique situation while also addressing fundamental needs (e.g., hygiene, feeding) in a non-mechanistic manner, an appropriately resourced workplace is required. It’s not enough to be empathetic and compassionate on the individual level, the environment should provide a nurturing setting, too. Social norms, such as trust, concern, and empathy as well as leaders demonstrating the meaning of noticing, paying attention and compassion could provide that. As medical facilities are about efficiency than settings for the greater well-being of BOTH patients and physicians, the lack of it might be another explanation for the global physician burnout epidemic.