Friday, October 25, 2019

Compassion in Medicine 2019 Number #39

Compassion in Medicine 2019

Global Veterinary Ethics Congress
Compassion in Medicine
Donald H DeForge, VMD
Fellow of the Academy of Veterinary Dentistry
Director: Silver Sands Veterinary
Director: Advanced Veterinary Dentistry

The Global Veterinary Ethics Congress [GVEC]
The Human-Animal Bond
The Preservation of the Five Freedoms
Addressing connections between Ethics and the Human-Animal Bond:

Compassion in Medicine 2019  
One Medicine

The Global Veterinary Ethics Congress will be studying Compassion in Veterinary Medicine in the months ahead.  Look at the video below concerning our human brothers and sisters in medicine. Jennifer Dobner in the essay to follow describes where we have been and where we should begin again in a quest for compassion in medicine.  It will only take a few moments to view the video and read the essay.  It is a gift well worth experiencing.

Donald H DeForge, VMD
Acting Chair-The Global Veterinary Ethics Congress

"At the beginning of medicine, when our knowledge was frankly limited or absent, what is it that we were able to provide?" asks Dr. James Doty, a neurosurgeon, who has practiced medicine for more than 30 years. "It was not cure. It was not intervention. The only thing we could provide was care and comfort."
Compassion isn't entirely gone from health care -- those working in the profession are still driven by a desire to ease suffering -- but in practice, it's a tenet that seems to have been lost or pushed aside over time, says Doty, the director and founder of the Center for Compassion and Altruism Research and Education (CCARE) at Stanford University.
"We've become enamored with the technology and the power of science," he says. "Certainly, they've had a huge impact on health and health outcomes. But we also have seen the result of negating that and what we have learned is that there is immense power to demonstrating compassion and caring to individuals who are ill."
Working to put compassion back at the center of health care systems will be the focus of Compassion Week, a joint initiative of CCARE, the Charter for Compassion, and the Tenyin Gyatso Institute, which seeks to instill compassion into the arenas of business and public service.
Dignity Health is a lead sponsor of the week's events that include the 2nd Science of Compassion Conference, the 3rd Empathy and Compassion in Society Conference, the Charter for Compassion Day, a "Living Compassionately" Retreat, a youth gathering, and the inaugural Compassion and Healthcare Conference.
Research has produced ample empirical evidence for proving what should seem obvious: Feeling soothed or cared for through the experience of meaningful social or human connections produces a physiological state in the body that is optimum for healing, Doty says.
The immune system gets a boost. Cortisol levels drop. Blood pressure goes down. Stress and anxiety begin to melt away and a person's mental state improves.
"I always tell people that while science and technology have probably saved millions of lives, the fact of the matter is that kindness and compassion have probably saved more," says Doty.
But it can be hard to hang onto compassion in an industry that has become increasingly complicated and expensive, relies on payment models that reward procedures over wellness care, and moves cautiously around legal and regulatory concerns, Doty and Dignity Health's Heather Walker say.
A pediatric nurse who now runs the Learning Institute Simulation Center at Dignity Health's St. Joseph's Hospital and Medical Center in Phoenix, Walker says she's watched nursing become heavy with requirements for documentation and creates mounds of paperwork.
"What I see lately is that health care is just so task-oriented," says Walker, who chose a career in nursing because she wanted to make a healing connection with others. "Many of those tasks are important, but we are just so focused on the tasks that we sometimes forget the patient because we are busy checking off all the boxes."
Part of Walker's job is to teach compassion skills to health care workers across the spectrum, from nurses and respiratory technicians to medical students and others. To do that, Walker uses a team of hired actors and volunteers to serve as "patients" in simulated situations -- known as the standard patient program -- to measure a health care provider's performance.
What she's watching for: How is the health care worker interacting with the patient? Are they looking the patient in the eye? Are they really listening? Is the patient understanding the information about medications?
"Everybody calls them soft skills, but I think they are hard, harder than just learning the technical stuff," says Walker, who plans to show a video from a simulation during a conference panel discussion.
The simulations include providing students with immediate feedback from their "patients."
Many get heaps of praise, but some are also surprised at how poorly they score on the compassion scale, even when the perceived infractions might seem small in the overall scheme of things.
"Like moving the bedside table closer. It's not a huge thing, but when a patient can't get to it and you leave the room, they're saying, 'wow, that's really rude''," she says. "We have to practice these things every day. I tell my students, what if this was your mother in your bed? Your child? What would you want for them?"
From Walker's perspective restoring compassion -- a touch, a listening ear or an acknowledgment of a patient's frustration or sorrow -- is an important way in which hospitals and other care facilities can differentiate themselves from each other.
Today, patients can readily find satisfaction surveys on the internet and made choices about where to seek treatment.
"As consumers, patients are really looking at whether they feel like they are being listened to," says Walker, who is slated as a presenter on a Wednesday conference panel. "So we really need to put the patient back into the center of health care and make sure we are taking care of the whole patient."
Doty believes the health care system is at an important crossroads that make this the right time for conversation and action around the idea of compassionate care.
"I think a lot of people understand the prices we have paid for ignoring this aspect of health care," he says. "There's an understanding that compassion is not only what defines our humanity but it defines us physicians and health care providers."
It's why, he says, the future of medicine resides in understanding the past and the beginnings of medicine.
Doty hopes conference -- goers will leave the event with a deeper understanding of the power compassion and caring can have on medicine and health care.
"It is fundamentally at its core," he says. "I want them to have a sense of excitement in regaining this part of medical practice and to give them some tools to use within their own environments that will not only support them in terms of resilience but also allow them to better re-engage with those they are caring for."
Salt Lake City-based Jennifer Dobner is an independent award-winning journalist and writer and a regular contributor to Reuters, The New York Times, WebMD, and NBC’s Today Show. Her resume includes stints at newspapers large and small across the western United States, and for seven years she was the lead reporter in the Salt Lake City bureau of The Associated Press. She has written extensively about the Mormon church, criminal justice, politics and health care. Before working in journalism, Dobner worked in sporting event management and media relations for sponsors of professional golf events and for a professional soccer team. Raised in the San Francisco Bay Area, she studied journalism at Fresno State University.

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