A compassionate care-giver who focuses on good communication and providing emotional support can make the difference between life and death for a hospitalized patient, the majority of doctors and patients said in a national survey to be released today by a Boston advocacy organization.
Dr. Beth Lown, a Mount Auburn Hospital internist and medical director of the survey’s sponsor, the Schwartz Center for Compassionate Healthcare, said she was shocked and encouraged that most doctors thought such factors could make a difference in whether a patient lives or dies.
"I think this is a knockout,” she said in an interview. Some “doctors feel that medical skills and scientific knowledge are the only things that turn into good outcomes. ... I think all patients have always wanted emotional support, but it hasn’t always been in the doctors’ lexicon.”
The survey found that doctors and patients agree on the importance of most but not all of the components of compassionate care, which include showing respect, listening attentively, giving information in a way that is understandable, involving the patient in medical decisions, and treating the patient as a person and not a disease.
But patients see a gap averaging 20 percentage points between the compassionate care they believe they should get and the care they say they received in the hospital, according to the telephone survey. For example, while 91 percent of patients believed doctors should listen attentively, only 67 percent said that’s what happened when they were in the hospital.
Eight hundred patients who had been hospitalized in the past 18 months for at least three days and 500 doctors who cared for patients in the hospital were questioned in September and October. The poll's margin of error was plus or minus 3.5 percentage points for questions asked of the full patient sample, and 4.4 points for questions asked of the doctors.
Patients and doctors agreed on the importance of clinicians’ showing sensitivity to patients while involving them in decision making about their care. But while 78 percent of patients rated getting test results in a timely manner as a 10 on a scale of 1 to 10, only 61 percent of doctors rated it that high. Asked how important it is for doctors to apologize if
they make a mistake, the gap was wider. Three-quarters of patients rated that a 10 while only a little over half of doctors did.
About half of patients said their caregivers provided compassionate care while they were in the hospital. Doctors disagreed: Three-quarters said health professionals gave compassionate care.
Most patients knew who was in charge of their care in the hospital, but 29 percent did not. About twice that -- 62 percent -- never heard from their primary care physician while they were in the hospital, perhaps a reflection of the growing use of hospitalists, or doctors who specialize in caring for patients in the hospital.
Even so, most patients said they were satisfied with their time in the hospital. But two-thirds say they are worried that changes in the heath care system will make it more difficult for patients to receive compassionate care. A little over half of the doctors agreed. The survey did not specify what those changes would be, making no mention of the federal health care overhaul.
Rob Restuccia, executive director of Community Catalyst, said he was not surprised by the differences between patient and physician responses. The mission of the Boston-based national advocacy organization is to build consumer participation in the US health-care system.
“Physicians are not necessarily aware of how patients feel about their care,” he said. “We are watching the health-care system get more complicated, more fragmented, and the ability of patients and physicians to navigate the system become more difficult.”
The Schwartz Center was founded in honor of health-care lawyer Kenneth B. Schwartz, who wrote movingly before his 1995 death from lung cancer about what compassionate care meant to him. Its name officially changes today, from the Kenneth B. Schwartz Center to the Schwartz Center for Compassionate Healthcare, to better reflect its national focus, executive director Julie Rosen said.
Schwartz Center Rounds, which are sessions for hospital professionals to discuss difficult emotional and social issues that come up in patient care, are now held in more than 200 hospitals in 32 states.
“We know anecdotally and we know from research that compassionate health care and communication in health care is a major issue in this country,” she said. “What I’ve learned is we have quite a bit of work to do.”
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|White Coat Notes covers the latest from the health care industry, hospitals, doctors offices, labs, insurers, and the corridors of government. Chelsea Conaboy previously covered health care for The Philadelphia Inquirer. Write her at email@example.com. Follow her on Twitter: @cconaboy.|
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