ECG’s radio show and podcast, Healthcare Upside/Down, offers unfiltered perspectives on what’s working in US healthcare and what’s not. Hosted by ECG principal Dr. Nick van Terheyden, each episode features guest panelists who explore the upsides and downsides of healthcare in the US—and how to make the system work for everyone.
Ask any doctor or healthcare worker why they got into medicine, and you’ll nearly always hear the same response—because they wanted to help people. That’s certainly my story, and it remains one of my driving principles.
And yet the news is filled with stories about patients’ dissatisfaction with the healthcare experience and providers leaving the profession on account of burnout. In some cases, the pressures of working in this industry have pushed individuals to do the unthinkable, as it did for some of my colleagues who took their own lives. For anyone reading this who is feeling a sense of loneliness, suffering from depression, or having any thoughts of suicide, please call 988.
So what happens to the compassionate idealists who endure the rigors of medical training only to leave the profession they worked so hard to break into? Look no further than the 2009 report in the Journal of Academic Medicine, “The Devil is in the Third Year: A Longitudinal Study of Erosion of Empathy in Medical School.” It demonstrated that the empathy score of medical students stays constant in the first and second years of medical school but plummets in the third year—and never again reaches the earlier level.
If medical students’ capacity for empathy is dwindling even before they enter residencies, what are the chances that we can deliver on the promise of patient-centered care?
Adrienne Boissy, MD, is a neurologist and the CMO at Qualtrics. On episode 77 of Healthcare Upside/Down, she talks about taking a holistic approach to caring not just for patients but also the staff who are responsible for them. Below are a few excerpts.
What we’re not asking about the patient experience.
“Hospitals are incentivized to ask about your experience. [They] send you a survey with 45 questions on it that asks about your perception of one hospital stay. That is not health, nor is it a comprehensive, holistic understanding of health. The [surveys] don’t ask about the things that are really important for the patient’s sense of feeling cared for. One of them is empathy. We don’t ask, ‘Did we care for you? Did we treat you like a human being? Did you feel cared for?’ The other questions we don’t ask are around safety. ‘Did you feel safe in our environment? Did we take care of your loved ones? Did we practice safely?’ That’s one opportunity for us to improve. We build trust in healthcare when we keep our promises to patients.”
Limitations of employee engagement surveys.
“On the employee experience side, the traditional approach is to ask employees once a year on an annual engagement survey with 55 questions on it. That’s an outdated way of listening. The touch points need to be much more frequent. Seventy-five percent of healthcare workers are anticipated to leave the profession by 2025; 38% of them are at risk for burnout. To me, that indicates we’re not listening effectively. I shouldn’t find out in a survey that you’re having a hard time. I should read the risk signals coming down the line and intervene much sooner.”
Recovering empathy.
“I don’t think any one of us is a number. And none of us are the role that we’re showing up for. I’m not a patient showing up for my patient appointment—I’m just a human trying to get through my life and my day. I think there’s tremendous opportunity around more deeply understanding who this person is, over time, and being conscious of context. What you want in an emergency situation might be quite different than what you want when everything’s fine. We need to recognize those complexities; it allows us to intervene differently.”
On the podcast, Dr. Boissy talks more about person-centered care and why, despite so many failings, people still trust healthcare.
Edited by: Matt Maslin
Published May 30, 2023