ACT With Compassion

“Is compassion important?” may seem like a no-brainer question, akin to “Do you like puppies?” But just how important is compassion in the medical profession?

Dr. Stephen Trzeciak, a physician in an intensive care unit and self-proclaimed ‘research nerd’ dove into the evidence base to investigate. After reading more than 1000 abstracts and 200 papers, he came to the conclusion that compassion isn’t just nice, it’s vital. It’s not just the cherry on top, it’s the whole sundae.

Compassion Crisis

Patients place a high value on compassionate care; 90% of Americans report feeling like switching healthcare providers after receiving unkind treatment.  

Yet, according to Dr. Trzeciak, we’re in a ‘compassion crisis’ with nearly 50% of patients thinking that the health care system does not provide compassionate care. In fact, two thirds of patients report experiencing a lack of compassion in a health care setting, including a failure to connect on a personal level, poor listening skills, or staff rudeness.

While electronic medical records speed efficiency, they may hurt patient-provider relationships. Health care providers spend about half of their time doing desk work, and when they are with patients, spend around a third of that time looking at a screen.

Compassion Improves Patient Outcomes

The benefits of compassionate care are far-reaching. Compassionate physicians, for example, are more meticulous, less error-prone and give patients more of their attention.

Perhaps less intuitively, compassionate care affects patients’ physiology. In a randomized controlled trial, the “gold standard” approach for testing the effectiveness of treatments, physician empathy predicted the duration and severity of patients’ common colds. In addition to boosting the immune response, compassionate care also predicts optimal blood sugar control in patients with diabetes.

All in all, physician compassion plays a key role in not just patient satisfaction, but also treatment outcomes. It appears to even help account for race-based disparities in treatment quality (e.g. African American patients typically receiving poorer treatment for pain than White patients).

There are many pathways that could link physician’s compassion to patient outcomes, including improved trust and a better understanding of the treatment. A big issue in the medical field is that many patients do not follow recommended treatments. Sure enough, a good relationship between a provider and patient greatly improves treatment adherence. Patients with HIV who reported that their clinician knew them as a person, for example, were 33% more likely to adhere to treatment and 20% less likely to have a detectable virus in their blood, according to one study.

Communication also plays an important role; the odds of a patient listening to a physician are 1.62 times better if the physician has been trained in communication skills.

Compassion Improves Physician Outcomes

Compassion doesn’t just benefit the recipient; it also benefits those who practice it. We recently reviewed 27 studies on lovingkindness meditation, showing the extensive benefits that come from cultivating compassion. To name a few, these benefits include increased positive emotions, slowed aging, decreased chronic pain, and increased social connection.

Dr. Trzeciak argues that compassion can help combat physician burnout; an issue that’s both widespread (affecting around 50% of physicians) and expensive (costing upwards of $100,000 per physician who turns over their job).

Conventional advice suggests that people experiencing burnout should disengage or step away from their work. But Dr. Trzeciak actually suggests the opposite. He believes that physicians would benefit from fully embracing compassion.  By truly sitting with patients, he believes that physicians can build up their resiliency for the tough work.

40 Seconds of Compassion

Most people agree that compassion is a valuable thing. But around 56% of physicians believe that they don’t have the time to show compassion towards their patients. With the pressures of medical school, researchers find that students’ empathy levels decline sharply when they reach their third year. This is particularly concerning since it is typically during this third year when students start rotations with patients.

But research provides an encouraging solution: communicating compassion doesn’t have to take long. In fact, it can be simple and brief. Forty seconds to be exact.

In a randomized controlled trial of cancer patients, half of the patients received compassionate words from their oncologist at the beginning and end of their visit. Physicians communicated the following: “I know this is a tough experience to go through. And I want you to know that I am here with you. Some of the things I speak to you about today may be difficult to understand, so I want you to be comfortable with stopping me if something I say is confusing or doesn’t make sense. We are here together, and we are going to go through this together.”

These simple words, which took just 40 seconds to communicate, predicted significantly less anxiety amongst the cancer patients.

Compassion Can Be Cultivated

Encouragingly, compassion is not a trait that some people have and others don’t. Instead, it’s like a muscle that grows with training. In order to be compassionate, you just have to value being compassionate and you have to practice.

Brief interventions, for example, can improve physician empathy. To sustain these improvements, empathy needs to be reinforced. These results suggest that a culture that prioritizes compassion would change the game.  

This isn’t just a story about compassion in the medical field. It’s not just physicians who experience burnout. And it’s not just physicians who can meaningfully impact others in even short interactions. The science of compassion is relevant to all of us—a win-win for both ourselves and others.

Empathy levels have declined over the years. It’s possible that people have simply become less kind. But I think it’s more likely because peoples’ beliefs have shifted. Some people, for example, believe that empathy is a limited resource, a zero sum game in which giving empathy to one person means you can’t give it to the next. And others believe that empathy is fixed over a person’s lifetime.

But the research paints a more optimistic picture. It suggests that compassion is neither fragile nor limited. Instead, it can be strengthened like a muscle. Compassion may be warm and fuzzy, but its importance is backed by cold, hard science.