A near-death experience opened this physician’s eyes to empathy

Residency Program Insider, June 16, 2017

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Medical doctors don't need to undergo a near-death experience to better engage with patients. What they need is empathy, says a pulmonary disease specialist who learned first-hand.

It took her own near-death experience in 2008 for Rana L.A. Awdish, MD, to comprehend the gulf in empathy that exist between hospital staff and the patients in their charge.

Awdish, who specializes in pulmonary disease, critical care medicine, and internal medicine at Henry Ford Health System in Detroit, Michigan, details her experience in a recent essay in the New England Journal of Medicine. She spoke with HealthLeaders Media about the need for understanding the patient perspective. The following is an excerpt from that interview. Click here to read the full exchange.

HLM: What happened in your experience as a patient that allowed you to see the lack of empathy that you had not seen as a physician?

My position changed from being the physician to being the patient, being in the patient's bed.

The things I thought my patients needed from me, the highly technical expert care we deliver so proficiently, I took that as a given. I knew that would happen.

I didn't know that as a patient I would have needs beyond that. That sounds naïve, that I perceived that all my patients wanted was to get well, but I truly saw suffering as an extension of the disease. I thought my role was to cure the disease, or at least treat it, and the suffering would be alleviated. There was no reason to tend to it in the moment because it would just delay solving the problem.

HLM: What have you done at Henry Ford to address empathy?

The first thing was to start a discussion. We developed programs that are professional development tools.

We spend all of our time in medical school and residency and fellowship learning clinical skills and content and we don't spend a lot of time developing our emotional intelligence, our narrative competence, our ability to get a history from someone that is authentic to who that person is, but not just trying to corral them into 'yes' and 'no' answers.

Everyone goes into medicine because they want to do right by their patients, and they don't want to harm them. We in medicine have a history of unintentionally harming our patients through our behaviors, and so we are all focused on changing that.

HLM: There are thousands of employees at hospitals. How do you get everyone on the same page?

No one has the resources to assign one-on-one care coordinators. When you orient people to a mission, when as an institution you let people know what their value is and not just their jobs, and you engage them in patient care in whatever position they are in, that they understand they are part of the care team, it translates across the culture.

These are not things that are specific to physicians and nurses. If you are in healthcare you need these skills because you have points of contact and you cannot imagine the impact you have on patients.

That is part of what we do at the new employee orientation. It is transporters, and billing clerks, and radiology techs, and everyone engaged in the process. To show them what it means to work here and the lives that you can impact, when maybe you don't think that that is what you signed up for when you signed up for the job. It changes the conversation.

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