‘Love and Compassion’ Category

Relationships and Healthcare – An Oxymoron?

Tuesday, December 22nd, 2009

A fundamental problem in healthcare is that relationships are brief and fairly short lived.  Relationships were broken by the creation of provider networks when managed care arrived and by the relatively easy movement of people about the nation following jobs and loved ones.   As a result, long-term relationships with a physician became a memory of the past.

Much has been written on relationship-centered care. Follow the link for one of the earliest and best works on it, the Pew Fetzer Task Force report. It specifies very practical ways to implement Relationship-Centered Care. It identifies specific knowledge, skills and values needed.  Some of them are to develop effective communication, engage a community and to improve ones self / health. The report also provides 6 principles which include expanding patient function and meaningfulness into all functions of life, reflective self-work, being close to the community and ongoing education.

Sadly more has been written than practiced when it comes to relationship based care. It is continually given lip service in many healthcare organizations; however it rarely crosses the threshold into action. What is required first is commitment to building relationships, and then becoming able to enter into and sustain them through self-work and an altruistic interest in the welfare of others.

When we have a national electronic medical health record, there will be an unbroken flow of information, which will prevent unnecessary and redundant tests and improve care for patients. However, we still have the human element of love, compassion and trust between two or more people that needs attention.  Relationships are essential to heal one’s self.  Let us focus on healing and relationships.

Compassion: Not An Industrial Model of Medicine

Sunday, December 6th, 2009

I have worked in allopathic or traditional healthcare for 12 years. I have seen extraordinary, compassionate caring that touched the patient’s life and heart in uplifting and healing ways. I also have witnessed cold, detached relations with a patient and their loved ones that left them feeling helpless and without comfort. As a patient I have left more physician office visits feeling depressed about my health than I care to recall.

Healthcare can be a noble profession. However, its noble garments are pretty tattered and worn. This is the results of the imposition of an industrial model of medicine on a profession of caring for human beings. Time, volumes of patients, productivity and margins are the measures of the industrial healthcare model. Industrial measures are focused on the immediate short-term. The hearts and souls of the practitioner and the patient are left disappointed and blocked by the short-term goals of financial health.

Many have heard the mantra so popular now: “No margin, No mission”. How many times is that used as an excuse to shave a few minutes off a patient conversation or eliminate a step in a process in the name of cost?! In the quality and process improvement world it well known, and unfortunately demonstrated over and over again, that when productivity is focused on, quality goes down and costs go up.

What I want as a patient is a healing relationship with my caregivers. Not a transaction. There are many caring individuals within health systems who are compassionate in the face of an organizational quest for margin. However, it is the entire system that needs to demonstrate loving care toward me as a patient. The system needs to say we will take care of you; we will help you consider the options, and we will create a healing space for you to have hope and a sense of control over what you are facing. As a patient I want the system to enable compassion and caring.

The Fetzer Institute is dedicated to compassion in the world. Check it out. Their work should inform the work of healthcare systems and organizations.