Heroes Not Zombies

I read an article in the Washington Post about a  book entitled “Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference,” by Stephen Trzeciak and Anthony Mazzarelli. Well, there’s a new word – “compassionomics”! I guess they are picking up on all the other “-nomics” people are describing these days to highlight networks of influence. The key point of the book is that in hundreds of studies looking at a huge diversity of outcomes, it seems having a doctor who is compassionate produces better results.

They cite things like

Research shows that the odds of patients having optimal blood-sugar control is 80 percent higher, even after controlling for age, socioeconomic status and gender. It also shows 41 percent lower odds of serious complications from diabetes.

and

Studies show that warm, supportive interactions from either doctors or nurses right before going in for surgery resulted in patients being more calm (with better achievement of adequate sedation) at the start of surgery and a decrease in the need for opiate medication following surgery. Patients also spent less time in the hospital.

They say you can figure out if the doctor is compassionate if they have the following behaviours –

• Sitting (versus standing) while speaking with you.
• Facing you and making eye contact.
• Caring about your emotional and psychological well-being.

And they shouldn’t interrupt you (remember that 2018 study from the Mayo Clinic which showed doctors first interruption occurs at 11 seconds into the patient’s description of their main problem?)

Patients who receive compassionate care recover more quickly from the symptom that brought them to the doctor, have fewer visits, tests and referrals. The proportion of these patients who are referred to specialists is 59 percent lower, and diagnostic testing is 84 percent lower.

And, to counter the belief that you might be best with a doctor who just has the best skills, irrespective of whether or not he or she is compassionate, they cite studies which showed “de-personalised” surgeons (the most distant ones) committed the greatest number of surgical errors.

Hey, who would have known? Giving a damn means you practice more carefully!

Now, I’m in two minds about this whole thing. I mean, I definitely believe that doctors should be compassionate. In fact, I think if you are a doctor or a nurse and you don’t care about the patients, you are in the wrong job. Compassion, for me, is THE core skill of any health care professional. Yes, yes, of course you want a doctor with good knowledge and good skills. That’s important too. But compassion is of fundamental importance. The whole philosophy behind these studies is utilitarian. It’s about producing “better outcomes”. That’s the bit I’m in two minds about. I’m not a die hard utilitarian but I do want patients to experience good “outcomes”. I guess I just think there’s more to it than that….I think the very experience of being cared for, being listened to attentively and non-judgementally….is a Good in its own right. I’d want that whatever the utilitarians could show….