Expert: Compassionate Care Is Not a Matter of Time

Research shows that clinicians can make a compassionate connection with patients in less than a minute.

The co-author of a book on compassion in healthcare says that clinicians who feel they do not have the time to make a compassionate connection with patients need a mindset change.

Many studies have shown that compassionate care generates positive outcomes. One study found that shifting from a low- to a high-scoring category of physician empathy decreased the odds of metabolic complications among diabetic patients by 41%. Another study found that homeless patients assigned to standard medical care plus compassionate contact from trained volunteers had 33% fewer emergency department visits and were twice as likely to rate their hospital experience highly.

Despite the widespread evidence on the benefits of clinicians showing compassion to their patients, a study found that 56% of physicians did not feel they had the time to be compassionate.

"That study begs the question—how long does it take to be compassionate?" says Stephen Trzeciak, chairman and chief of the Department of Medicine at Cooper University Health Care in Camden, New Jersey, and chairman of the Department of Medicine at Cooper Medical School of Rowan University in Camden. Trzeciak is co-author of the book Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference.

It takes very little time for clinicians to be compassionate with patients, he says. "We devote a whole chapter in Compassionomics to the issue of time. We found the scientific evidence that timed being compassionate. There have been several studies in the literature, and what they have all found is that it takes less than a minute to make a meaningful, compassionate connection with a patient."

To illustrate that it takes little time for clinicians to be compassionate, Trzeciak cited a Johns Hopkins study involving survivors of breast cancer. The breast cancer patients were exposed to two different interactions with oncologists. One interaction was purely informational, and the experimental arm of the study had an interaction that was both informational and compassionate.

"What they found was that the experimental arm compared to the standard informational arm had a statistically significant reduction in anxiety among the cancer survivors. In the experimental arm, oncologists provided the same consultation with just a little bit of extra communication before and after the purely informational interaction. There were statements such as, 'We are here together. You are not going to go through this alone. I am here with you,'" he says.

In the Johns Hopkins study, the amount of time devoted to being compassionate was negligible, Trzeciak says. "Just 40 seconds of extra communication with those types of statements generated a statistically significant reduction in the anxiety of these cancer patients using a validated scale to measure anxiety. Even what some people might consider to be small doses of compassion make not only meaningful differences for patients but also measurable differences for patients."

For clinicians, having time to be compassionate is a matter of perception, he says. "It all goes to mindset. When clinicians say, 'I don't have enough time,' the data shows that being compassionate does not take you any longer. Mindset is the most important factor. It is just not true that being compassionate takes more time—we just think that it does. That is what the evidence shows."

Organizational benefits

Employing clinicians who show compassion to their patients has benefits for healthcare organizations, Trzeciak says. "More compassionate care is associated with higher quality care, fewer medical errors, and higher patient satisfaction."

When clinicians show compassion to their patients, it improves patient experience, he says.

"When you look at surveys of patients, they talk about the relational aspects of healthcare. They do not talk about the technical aspects of healthcare. Some clinicians find that surprising; but, in general, most patients believe that their doctors and nurses know what they are doing. They just presume technical proficiency. What they want is the caring part of healthcare."

Compassionate care has a powerful impact on patient experience and the financial gains that a positive patient experience can generate, Trzeciak says.

"There is compelling evidence that, on average, healthcare organizations that do better with patient experience do better in terms of financial performance. Compassion matters for overall patient experience, and patient experience drives bottom line."

Healing the healers

Compassionate care also helps address clinician burnout, he says. "There is evidence that compassion for others can be a powerful therapy for the giver. The evidence in the literature shows that compassion is beneficial for the giver in that compassion for others promotes resilience and resistance to burnout."

Compassionate connections and strengthening relationships with compassion help prevent clinician burnout, Trzeciak says.

"We all know about the burnout crisis in healthcare and the costs of burnout in terms of employee turnover. The preponderance of evidence in the scientific literatures shows that compassionate connections with others and the quality of your relationships—whether it is the quality of relationships with your patients or relationships with colleagues—are the key to resilience and resistance to burnout."

Given the benefits of compassion for patients, healthcare organizations, and clinicians, it should be viewed as an integral part of medicine, he says. "What we found is that compassion matters, not just in sentimental and emotional ways but also in evidence-based ways. We consider compassion to be part of evidence-based medicine."