How 40 Seconds of Compassion Could Save a Life | Stephen Trzeciak | TEDxPenn

[Music] [Music] in my job I meet people on the worst day of their life I'm an intensivist a physician who specializes in intensive care medicine if you become my patient it's because you need life-sustaining therapies in the ICU lately I've been rethinking how I care for people let me tell you why on February 27 2007 on a snowy stretch of highway outside of Uppsala Sweden two buses collided head-on this is what was left of one of the buses six people died but miraculously 56 people were saved five years later researchers asked the question what do survivors remember they interviewed every survivor and using a rigorous qualitative research methodology they found two common themes in the data the first was expected the physical pain that they felt at the moment of impact but the other theme a lack of compassion from the caregivers and all the hospitals that's what they remembered five years later these data have begun to open my eyes to a stark reality in health care we are in the midst of a compassion crisis scientists define compassion as an emotional response to another's pain or suffering involving an authentic desire to help it's different from sympathy or empathy which are the feeling and understanding components in that compassion also involves taking action so here are the data research from Harvard University found that nearly 50% of Americans believe that our health care system and our providers are not compassionate two-thirds of patients have had a meaningful health care experience with a lack of compassion rigorous research show that if that 70% of opportunities for compassion are missed by physicians and compassion comprises less than 1% of all communications by physicians to patients these data are compounded by an epidemic of burnout and health care providers burnout is characterized by depersonalization which is an inability to make a personal connection and in the era of electronic medical records rigorous research shows that health care providers spend more time looking into computer screens than looking patients in the eyes based on all of these data I conclude we have a compassion crisis indeed but here's the big question does it matter does compassion really matter now you may say of course compassion matters we have a moral imperative it's part of the art of medicine and of course I agree but is compassion just in the art of medicine or are there also evidence based effects belonging in the science of medicine and what is the evidence in addition to being an intensivist I'm also a physician scientist in other words I'm a research nerd I like data and my hypothesis was a compassion matters for patients for patient care and for those who could care for patients so I went to the biomedical literature and I used a methodology called systematic review so over two years through the National Library of Medicine I reviewed more than 1,000 scientific abstracts more than 200 research studies in total and today I share with you what I found the effects of compassion on patients on patient care and specifically the cost of care and on those who care for patients are health care providers there are more than 20 distinct mechanisms of action by which compassion can have beneficial effects on patients let's go to the day let's start with the practical if you have compassion for patients you may be more likely to be meticulous about their care or have higher quality standards and lower likelihood of making a major medical error but there are also physiological effects compassion can buffer stress mediated disease compassion can also modulate a patient's experience of pain there are neuro endocrine effects so in patients with diabetes research shows that - compassion is associated with an eighty percent higher odds of optimal blood sugar control and forty percent lower odds of acute metabolic complications there are also immune system effects so in a University of Wisconsin study in patients with the common cold - compassion as rated by patients was associated with enhanced immune response shorter duration of symptoms and lower severity of symptoms and importantly compassion can can impact patient self care if you care deeply about patients and they know that they may be more likely to take their medicine in a Johns Hopkins study of 1,700 patients with HIV researchers ask patients does your physician know you as a person knowing the patient as a person was associated with 33 percent higher odds of adherence to therapy and 20 percent higher odds of having no detectable virus in the blood compassion has also been associated with lower health care costs which are a major factor in the health of our economy in primary care for example research from the University of Rochester and UC Davis have shown that compassionate patient-centered care is associated with lower discretionary resource utilization so fewer diagnostic tests fewer referrals to specialists fewer unnecessary hospitalizations and lower total health care charges so here's the bottom line if healthcare providers actually spend more time talk to patients maybe we don't need so many tests and referrals but what about time we've all heard the expression time is money but time is also a vital factor in the efficiency and the economics of health care so here's a staggering number 56 research from Harvard University shows that 56 percent of physicians believe they do not have time for compassion this is in the context of a classic study from Princeton University on helping behaviors which found that it wasn't the intrinsic belief of the importance of helping by the potential helper it was whether or not the potential help her believe they had enough time to help so how long does it actually take for a meaningful expression of compassion to address this researchers from Johns Hopkins University did a randomized control trial in patients with cancer who were having a consultation with the oncologist and in this randomized trial the primary outcome measure was anxiety and if you have cancer that's a pretty important outcome measure so they found that patients randomized to a compassion intervention from the oncologist had less anxiety than usual care so what was the compassion intervention I could describe it for you but instead I'm just gonna read it to you from the oncologist at the beginning of the consultation I know this is a tough experience to go through and I want you to know that I am here with you some of the things that I say to you today may be difficult to understand so I want you to feel comfortable in stopping me if something I say is confusing or doesn't make sense we are here together and we will go through this together and at the end of the consultation the oncologist said I know this is a tough time for you and I want to emphasize again that we are in this together that will be with you each step along the way so how long did that take they timed it 40 seconds so this randomized trial shows that all you need is 40 seconds of compassion to make a meaningful difference importantly 40 seconds of compassion can be a powerful therapy for the giver - and this is important because these data are not just applicable to health care workers but to everyone here today science shows that compassion for others can have a direct positive effect on your own well-being neuroscience studies show that compassion for others can trigger reward pathways in the brain and positive emotion that can buffer or even counteract the activation of stress pathways and negative emotion so in a fact compassion for others can make you forget your own worries at least temporarily so now this is where the science meets the personal a couple of years ago after nearly 20 years of working in the ICU and meeting people on the worst day of their life I came to a stark realization I had almost every symptom of burnout and let me assure you that's not a good place to be it can be a dark place currently the recommended prescription for burnout is what I call escapism get away detach pull back go on some nature hikes or whatever but I was not buying it because I believed I believed that the antidote to burnout had to be at the point of care in personal connection human connection not an escape - what was I supposed to do well I did the only thing I knew how to do I took the research nerd approach and armed with the data that forty seconds of compassion can be a powerful therapy for the giver - I decided to do an experiment now myself I was the only research subject in this experiment I was the N of one so I tested the hypothesis that my 40 seconds of compassion would transform my experience I connected more not less cared more not less leaned in rather than pulling back and that was when the fog of burnout began to lift my 40 seconds of compassion changed everything for me now you might be thinking I'm speaking on the power of compassion I must be the most compassionate doctor but but the truth if I'm being honest is that I'm still a work in progress I'm working hard at compassion every day but I see it now and thankfully science shows that change can't happen I used to think that people were either wired for compassion or they were not but the preponderance of evidence in the scientific literature both in health care workers and in the general population shows quite clearly that compassion that behaviors can in fact be learned and that is good news indeed so now it's time to answer the big question that I posed to you at the beginning does compassion matter my systematic review of the literature now complete 1000 scientific abstracts 200 research manuscripts and one life-changing and of one experiment behind me I now conclude with confer compassion matters for patients for patient care and for those who care for patients compassionate care belongs in the domain of evidence-based medicine I no longer believe in this paradigm behind me this historical paradigm I now believe in this one because I found that there is science in the art of medicine and the science is strong I like to call this field compassion ah mcc's it's the convergence of the science and the art of medicine I will close just by acknowledging that you don't have to be a healthcare worker to feel burned out and if you do I suggest that you test the compassion hypothesis for yourself do your n of one experiment look and see those in round around you in need of compassion and give them your 40 seconds of compassion see how it transforms your experience but don't do it because I say so do it because science says so 40 seconds of compassion can change everything for a patient it changed everything for me it can change everything for you too and that is the power of 40 seconds thank you [Applause]

Channel: TEDx Talks

Views: 41,244

Rating: 4.9278555 out of 5

Keywords: TEDxTalks, English, Social Science, Community, Compassion, Medicine

Id: elW69hyPUuI

Length: 15min 4sec (904 seconds)

Published: Tue Jun 05 2018