Of all the things I heard at the Transform symposium at the Mayo Clinic last week, there was just one notion that pierced the heart of all this healthcare reform talk, if you ask me. It was the statement by Christi Dining Zuber, Innovation Director at Kaiser Permanente, that healthcare needs to be about compassion rather than "compliance."
The traditional notion of a doctor's role was: "you tell people to do stuff, you push them to do it, and then you track it." Funny that when large numbers of people failed to perform the "stuff," no one seems to have thought about critiquing the methods. Rather, experts just assumed that patients were too lazy or stubborn to follow orders.
"Health care is humans giving care to other human beings," Zuber said. "It has to be about compassion, an appeal to the heart."
I wonder how many of us have had a compassionate encounter with a healthcare provider? Far more common are the horror stories of patronization and blame. Even I could tell you a dozen or more stories of being belittled by a doctor or nurse, and I'm a pretty pushy lady.
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The reason I'm encouraged is that Zuber wasn't the only one bashing the "compliance" terminology. I've been to numerous health conferences in the past months, and one after another, experts — including MDs, health plan executives, and health policymakers — take the stage and talk about "motivating behavior change" and "working with patients as partners." Just buzzwords? Hopefully not. At least talking about it is a good start.
That brings me to two things about the power of talking:
First: The night before my presentation, I went to dinner with a small group of attendees. Somehow we got on the subject of my diagnosis, and I ended up recounting all the gory details of near-starvation weight, blurry vision, dehydration, IVs, insulin overdoses, etc., etc. I could see that these folks were visibly shaken. Wow! what a story... you poor thing! But soon they snapped back into "professional mode," lamenting that patients don't follow this or that regime properly. And all I could think was: Do you think I'm the only one with a story like that?! Every patient has been through his or her own little corner of hell. Why can't you connect those life experiences with our "openness" or ability to perform some pretty unpleasant health tasks day in and day out, for the rest of our lives?
Second: The conference wrap-up was delivered by a brilliant woman named Maggie Breslin, Senior Designer at Mayo's SPARC research group. After years of studying every imaginable sort of patient interaction in this million-square-foot clinic, what do you think her conclusion is about what good healthcare looks like?
The answer: A satisfying conversation!
"Conversation is how people determine quality and value," she says. "People love the Mayo Clinic not because of all their state-of-the-art treatments and procedures, but because doctors take the time to talk and answer all patients' questions."
Her other conclusions, which seem so intuitive for us patients desperate for a good talk:
- Conversation has therapeutic value. Providers help patients just by talking with them.
- Conversation allows us to deal with ambiguity. It clears up all that confusing science and medical jargon, so we can understand our health issues.
- Conversation is not just a "nice to have"; it's the essential element of healthcare. Without it, you have nothing.
I couldn't agree more. So who out there is actually getting Compassion and Conversation from their doctor or CDE when they need it most?