Capella Health

The Cost of Caring and the Price of Antipathy

By Erik Swensson, MD, FACS
Senior Vice President, Chief Medical Officer

We hear sometimes that doctors don’t care about their patients or show empathy for their suffering. And while news like that is more often the result a single sensationalized story rather than an indictment of the profession as a whole, the fact is that physicians are not always as good at showing empathy for our patients or their loved ones as we need to be.

How we communicate is more important now than ever before as we enter this new era where pay will be based on performance (which includes patient perceptions). This new era also includes great transparency as consumers post reviews on-line for the world to see about seemingly every experience they have – from restaurants to plumbers to physician visits.

As you well know, complete care today goes beyond being an excellent clinician. Those who are most successful will be excellent communicators whose patients know they care.

The Studer Group has identified several tools and tactics that can assist with crucial elements of doctor/patient communication. Specifically the use of AIDET®, a foundational communication tool in use throughout Capella’s family of hospitals, is proven to relieve anxiety, foster compliance with discharge instructions, increase patient satisfaction, and much more. Dan Smith, MD, who is a Coach with The Studer Group, provides these tips to use during your next patient visit – whether in your practice or at the hospital.

1. Make eye contact and use key words with the patient. If using Electronic Health Records (EHR), open up the EHR to the patient so they can see what you are viewing. It can be difficult to simultaneously attend the screen and our patient. Try saying “I’m looking at this screen to ensure I accurately review your health conditions, recent visits and medication…know that I am listening to your every word and taking notes as we proceed.” This explains why we may not be looking directly at them but lets them know you are still listening, processing and caring about them as a person. 
2. Sit whenever possible. Occasionally we tend to stand at the end of the bed out of convenience or to save time. It only takes a few seconds to position ourselves in proximity of the patient. Involve them in the conversation and make them an active part of their care plan. Studies show that patients overestimate the time that physicians spend with them during an exam when they are seated versus standing. 
3. Use language our patients can understand. Describe the medication in a way that they comprehend and then use the “teachback method.” Ask them to repeat what you just told them to ensure they fully understand the reason and possible side effects of the medicine or treatment. Avoid medical jargon if at all possible. Patient’s recollection of this information may be short-lived so ensure it is replicated in a written form that they can read and understand. Staff can reinforce this prior to completion of the visit. 
4. Set staff and the whole team up for success. “Manage up” the care team to the patient and in turn, the team will manage you up. This shows our patients that a connected and united team is caring for them and reiterates that they will receive excellent care. For example, “Mrs. Jones, I’ve discussed the treatment plan with your nurse, Jackie, and ordered some medications to ease your nausea and pain. Jackie is one of our best and we have worked together for over 15 years.

Patients today desire communication with their physicians that garners respect, trust, alignment and understanding—a truly shared approach to their healthcareneeds. It’s an approach that shows them you “care” and are empathetic to their needs. By implementing the above tactics, a “win-win” is created: patients attain better health outcomes and comply closer with treatment regimens plus providers fulfill their mission of evidence-based, complete care and end each day knowing they maximized their impact. In turn, HCAHPS and perception of care surveys elevate as a by-product of our tactical communication during which we are effective in conveying empathy, compassion and clinical excellence.

If we aren’t successful in communicating effectively and showing empathy for our patients, they will feel we don’t care about them so we must be aware of our emotional response to situations that we may find uncomfortable. Having to be in the presence of a grieving family that is suffering a loss, because we did not save their loved one, is sometimes too much for us and so we leave the situation. The reality is that in addition to treating the physical, we have a unique opportunity to help heal the grief and despair of the family just by being there and listening. We should not shy away from this responsibility but should embrace it as another gift of being part of the medical profession. These most difficult emotional moments will be remembered by the family the rest of their lives and will impact how they view physicians as much or more than any other event they might experience. If we understand our significance in these times we will grow from the experience. The real art of healing is often what we do after our treatments don’t work.

For today’s physicians with the many levels of stress we have to deal with, I have found it useful to remember the words of Reinhold Niebuher, which were used by the our military forces in WWII, “God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”  We owe it to our patients, ourselves, and our colleagues to ALWAYS be caring and show empathy, as without these emotions – or rather without purposefully choosing to communicate them effectively – we become unworthy of the trust our patients have placed in us.

2013 National Physician Leadership Group Appointed;
Dr. Matthew Bliven Named Chair

Matthew Bliven, MD, a Family Practitioner at Willamette Valley Medical Center (McMinnville, OR), has been named Chair of Capella Healthcare’s 2013 National Physician Leadership Group. Other members of the group include:

• Greg Blackner, MD, Capital Medical Center (Olympia, WA)
• Hugh Don Cripps, MD, DeKalb Community Hospital (Smithville, TN)
• Victoria Damba, DO, Mineral Area Regional Medical Center (Farmington, MO)
• Alan Drake, MD, Highlands Medical Center (Sparta, TN)
• Jay Gregory, MD, EASTAR Health System (Muskogee, OK)
• Kevin Hale, MD, National Park Medical Center (Hot Springs, AR)
• Rick Harrison, MD, Saint Mary’s Regional Medical Center (Russellville, AR)
• Richard Levine, MD, Grandview Medical Center (Jasper, TN)
• Stephen Snell, MD, Southwestern Medical Center (Lawton, OK)
• James Spurlock, MD, Stones River hospitals (Woodbury, TN)
• Todd Stewart, MD, River Park Hospital (McMinnville, TN)

Erik Swensson, MD, FACS, Chief Medical Officer of Capella, has senior leadership responsibility for facilitating the work of the NPLG.

“A large part of our success is due to the leadership and engagement of the physicians at our hospitals,” said Capella’s Chief Operating Officer and Senior Vice President Michael Wiechart. “Frankly, we can’t be successful unless physicians play a key role in all major decision-making processes.  As we’ve worked with each of our hospitals to fully engage and partner with physicians, we’ve validated the direct relationship between medical staff satisfaction, improved quality and increasing volumes.  We’re seeing significant and sustained increases in all three of these vital areas.  The leadership and trust of our physicians is key to that success.”

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