The next revolution in health care? Empathy | Paul Rosen | TEDxWilmington

Summary

The speaker recounts a personal story of his father-in-law's lung cancer diagnosis and the impersonal hospital experience that followed, highlighting the need for empathy in healthcare. He discusses the frustrations of delayed appointments, emergency room wait times, and the importance of patient comfort during procedures. The talk emphasizes the epidemic of caregiver burnout and its impact on empathy, urging a redesign of the healthcare system centered around patient needs and experiences to improve medical outcomes and satisfaction.

Takeaways

• 👨‍⚕️ The script highlights the importance of treating patients as individuals, not just medical cases.
• 🏥 The speaker recounts a personal story about their father-in-law's experience with cancer and the impersonal nature of hospital care.
• 📈 The script points out that delays and inefficiencies in healthcare can be frustrating and sometimes harmful to patients.
• 📆 Modern scheduling techniques, such as Q Theory, can help reduce wait times and improve patient access to appointments.
• 🚑 The emergency department's efficiency is crucial, and many hospitals are working to reduce wait times and improve patient flow.
• 🧒 Pediatric care emphasizes comfort and minimizing pain during procedures, which can also apply to adult care.
• 🩺 The script suggests that healthcare professionals should always consider ways to decrease pain and anxiety for patients.
• 🌙 The practice of waking patients early for blood tests is outdated and can be changed with modern technology.
• 🔥 Burnout among healthcare professionals is a significant issue that can affect patient care and needs to be addressed.
• 🤝 Empathy in healthcare is essential, and restoring it can lead to better patient experiences and outcomes.
• 🌟 A healthcare system designed with empathy in mind would prioritize patient comfort, communication, and choice.

Q & A

What was the initial symptom that led to the discovery of Sully's cancer?

Sully was experiencing pain in his shoulder while swimming, which was initially thought to be tendonitis or another overuse injury.

What was the actual cause of Sully's shoulder pain?

The shoulder pain was a symptom of a tumor in his cervical spine, which was a result of lung cancer that had metastasized.

How did Sully feel about his treatment in the hospital?

Sully felt like he was not being treated as a person. He mentioned that hospital staff did not introduce themselves, smile, or explain what they were doing, and he felt like a piece of meat being moved around.

What was the specific issue with Sully's scheduled test involving sedation?

Sully was supposed to have a test with sedation but was not informed that it had been canceled due to a trauma case, and he was not allowed to eat because of the sedation, which was an oversight by the hospital staff.

What did the speaker reflect on when standing in the hospital family lounge?

The speaker reflected on the irony of being in a world-renowned hospital with a reputation for excellence, yet his loved one did not feel like he was being treated like a human being.

What historical perspective did the speaker provide regarding patient-centered care?

The speaker mentioned Henry Ford's 1915 critique of the Henry Ford Hospital, which was designed to fit the needs of physicians rather than patients, and questioned how much progress has been made since then.

What is one modern scheduling technique mentioned to improve patient access to appointments?

The use of Q Theory to manage patient appointments and reduce wait times.

How are some hospitals addressing delays in the emergency room?

Some hospitals are tackling delays in the ER by smoothing out their flow upstairs to prevent those delays from impacting the emergency department, and allowing patients to make appointments for the ER online.

What measures can be taken to decrease pain and discomfort during medical procedures?

Measures include using distraction techniques, numbing cream, nitrous oxide for sedation, and offering comfort measures to decrease pain during procedures.

Why have hospitals traditionally collected blood samples from patients at 4:00 a.m.?

Traditionally, it took hours to process blood tests, and doctors wanted the lab results for their morning rounds. However, with current technology, blood tests can be processed much faster, eliminating the need for early morning collections.

What impact does caregiver burnout have on patient care?

Burnout among caregivers can be a barrier to empathy, leading to increased medical mistakes, patients being less likely to take their medications, and poorer disease control.

What is the speaker's vision for a healthcare system designed with empathy?

The speaker envisions a system where doctors wash their hands 100% of the time, patients have uninterrupted time to tell their story, appointments are readily available, medical advice is accessible via mobile devices, and hospital care focuses on healing, nutrition, sleep, pain control, and communication.

Outlines

00:00

🏥 In-Hospital Experiences and the Need for Empathy

The speaker shares a personal story about their father-in-law, Sully, who was diagnosed with cancer after experiencing shoulder pain during swimming. Sully's hospital experience highlighted a lack of personal care, as staff failed to introduce themselves, explain procedures, or acknowledge him as a person. This led to feelings of dehumanization, despite being in a renowned hospital. The narrative points out systemic issues in healthcare where patients' needs are not prioritized, drawing a parallel to Henry Ford's critique from 1915 about hospitals being designed for physicians, not patients. The speaker reflects on common frustrations in healthcare, such as long wait times for appointments and procedures, suggesting that modern scheduling techniques could alleviate these issues.

05:02

🩺 Improving Patient Comfort and Decreasing Healthcare Delays

The speaker discusses ways to improve patient comfort, particularly in pediatrics, during procedures like blood draws and IV placements, using distraction, numbing creams, and even the presence of a therapy dog. They emphasize the importance of minimizing pain and fear for both children and adults. The narrative also addresses the outdated practice of waking patients early for blood tests, suggesting that with modern technology, there's no need for such disruptions. The speaker advocates for letting patients sleep and heal, reflecting a broader need to improve the patient experience. Additionally, the paragraph touches on the epidemic of burnout among healthcare professionals, which can hinder empathy, and the need to address this issue to improve patient care.

10:03

🌟 Prioritizing Empathy in Healthcare

The speaker calls for a redesign of the healthcare system based on empathy, starting with simple measures like ensuring doctors wash their hands more frequently and allowing patients two minutes to tell their story uninterrupted. They envision a system where appointments are easily accessible, medical advice is readily available through mobile devices, and hospital care is centered around healing, nutrition, sleep, pain control, and communication. The speaker shares an anecdote about parents expressing gratitude for the compassionate care their son received, emphasizing that this should be the standard experience for all patients. The story of Sully, who was not one to accept the status quo, is used to inspire advocating for better healthcare that prioritizes patients' needs.

Keywords

💡Empathy

Empathy refers to the ability to understand and share the feelings of another. In the context of the video, empathy is a critical component of patient care, where healthcare professionals should be able to connect with patients on a human level. The script illustrates this through the story of Sully, who felt like he was not being treated as a person during his hospital stay, highlighting the lack of empathy in his treatment.

💡Patient Experience

Patient experience encompasses all interactions a patient has with the healthcare system, from the moment they enter until they leave. The video emphasizes the importance of a positive patient experience, using Sully's story to show how impersonal and dehumanizing the current system can be. The script suggests improvements such as better communication, personalized care, and respect for patients' dignity.

💡Burnout

Burnout is a state of emotional, physical, and mental exhaustion caused by prolonged stress. It is particularly prevalent among healthcare professionals, as discussed in the script, leading to a decrease in empathy and an increase in medical errors. The video suggests that addressing burnout is crucial for improving patient care and outcomes.

💡Tumor

A tumor is an abnormal growth of cells. In the script, Sully is found to have a tumor in his cervical spine, which originated from lung cancer. This discovery is a pivotal moment that triggers a series of events highlighting the deficiencies in the healthcare system from a patient's perspective.

💡Healthcare System

The healthcare system refers to the organization and management of healthcare services and resources. The video critiques the current system for not prioritizing patient needs, using examples such as long wait times for appointments and lack of personalized care. It calls for a redesign based on empathy and patient-centered care.

💡Procedure

A procedure in healthcare refers to any medical or surgical intervention. The script discusses the need to minimize pain and discomfort during procedures, such as using numbing cream or nitrous oxide for sedation. It emphasizes the importance of patient comfort and reducing anxiety associated with medical interventions.

💡Sedation

Sedation is the use of medication to induce a state of calmness or drowsiness. It is mentioned in the context of children needing to undergo uncomfortable procedures, such as blood draws or IV placements. The video advocates for the use of sedation to ensure that patients do not have painful memories of these procedures.

💡Appointment Scheduling

Appointment scheduling is the process of booking a time for a patient to see a healthcare provider. The script points out the frustration of long wait times for appointments and suggests modern scheduling techniques to improve access and reduce delays.

💡Emergency Room

The emergency room (ER) is a department in a hospital that provides immediate care for patients with urgent medical needs. The video discusses the issue of long wait times in the ER and suggests that these delays are solvable, emphasizing the need for efficient patient flow and timely care.

💡Medical Mistakes

Medical mistakes refer to errors in the treatment of patients that can lead to harm. The video links medical mistakes to a lack of empathy and burnout among healthcare professionals, suggesting that a more empathetic healthcare system could reduce these errors.

💡Patient-Centered Care

Patient-centered care is an approach to healthcare that prioritizes the patient's needs, values, and preferences. The video advocates for a healthcare system that is designed around the patient, ensuring that their care is personalized, respectful, and responsive to their individual needs.

Highlights

In-laws visited for Thanksgiving and father-in-law experienced shoulder pain.

Father-in-law diagnosed with a tumor in his cervical spine from lung cancer.

Lack of personal care and communication during hospital stay led to feelings of dehumanization.

Hospital staff often fail to introduce themselves or explain procedures to patients.

Transport staff do not acknowledge patients as individuals.

Hospital errors in scheduling and communication lead to patient distress.

The need for modern scheduling techniques using Q Theory to improve patient access.

Emergency room wait times are a significant issue in healthcare.

Hospitals are implementing solutions to reduce emergency room delays.

Comfort and pain management during procedures can be improved with various techniques.

Healthcare professionals should consider every way to decrease pain and anxiety for patients.

The practice of waking patients early for blood tests is outdated with modern technology.

Burnout among healthcare professionals is epidemic and affects empathy.

Empathy in healthcare can reduce wait times and improve patient outcomes.

Healthcare systems focusing on empathy make fewer medical mistakes.

A commitment to empathy in healthcare leads to better patient experiences.

Hospital CEOs prioritize improving the patient experience.

Redesigning healthcare with empathy could lead to significant improvements.

The story of Sully, who challenged the status quo and taught the importance of fighting for what you believe in.

The call to demand a healthcare system that puts patients first.

Transcripts

in November 2005 uh my in-laws came over

for Thanksgiving I like my

in-laws this is a different

story after dinner my father-in-law

Sully was telling me that he was having

some pain in his shoulder for the last

few weeks when he was swimming I thought

maybe it was tendonitis or some other

overuse injury and we talked about when

he got home him going to see his regular

doctor for a checkup 3 weeks later my

mother-in-law called Sully was in the

hospital the doctors found a tumor in

his servical spine it was

cancer the primary tumor came from lung

cancer it was

fatal I flew up north and visited Sully

in the hospital the day he the day after

he had his surgery to debulk the tumor I

walked into the hospital room he was

sitting up with a neck collar on and

asked how he was doing he said he was

doing okay the surgery went well he was

getting good medical care but he didn't

feel like he was being treated as a

person and I asked him to explain what

he meant he said well the hospital staff

are coming in my room and they don't

introduce themselves they don't smile

they don't explain to me what they're

going to do and then they walk

out and he said I've been getting a lot

of tests today and the transport staff

you know put me in a wheelchair they

wheel me

downstairs they talk to the other staff

but they don't talk to me they don't

acknowledge me as a person I kind of

feel like I'm a piece of meat getting

carted around from place to

place and I'm hungry I'm supposed to

have a test today with sedation and

because I'm getting sedated I I can't

eat and I said Sully it's 9:00 at night

are you sure you're getting this test he

said I'm getting this test they promised

me I would get this test today so I said

well let me check so I found the

resident and asked and she said oh um

you know a trauma case came into the

hospital this morning and your

father-in-law's uh procedure was

cancelled we should have put in an order

so that he could eat but it was an

oversight I remember standing in the

hospital family Lounge looking at the

city skyline and thinking to myself

what's wrong with this picture I'm

standing in one of the world's most

famous hospitals with one of the best

reputations and my loved one does not

feel like he's being treated like a

human

being something's

broken in 1915 Henry Ford took a tour of

the brand new Henry Ford Hospital when

he finished his tour he turned to the

hospital administrator and said well I

see you've designed the hospital

perfectly to fit the needs of the

Physicians instead of the

patients 100 years later how much

progress have we made have you had an

experience in healthcare where you felt

that your needs were not put

first have you ever called the doctor's

office for an appointment and you were

told you had to wait a week or a

month did you ever call a sub specialist

and were told you had to wait two

months a lot of us have had this

experience and it's

frustrating but what if you were calling

for help for your elderly mother or your

child and it doesn't have to be this way

there are modern scheduling techniques

we can use that use Q Theory to get

patients access to the appointments they

need now whenever I mention waiting in

healthcare many people think back to

their last visit in their local

emergency

room and uh right and uh my colleagues

in emergency medicine always yell at me

when I when I talk about the emergency

room and they tell me we don't work in

an emergency room we don't work in a

room we work in where Department it's

the emergency department not the

emergency room okay fine it's not a room

but if you're making people wait for six

hours I'm not sure it's an emergency

either we can measure the time it takes

to get to see a triage nurse the time it

takes to wait to see the doctor the time

it waits to get uh the time time it

takes to get blood tests back to get an

x-ray to get another Consulting

physician to come downstairs and then

the time it takes to get admitted up to

the hospital or sent home and all these

steps can have delays and make for big

uh we times in the emergency room and if

the hospital upstairs is crowded or if

they're short staffed then those delays

will trickle down to the emergency room

but many hospitals are tackling delays

in the ER and they're working on

smoothing out their flow upstairs so

those delays don't impact the flow of

patients downstairs other hospitals are

letting patients make appointments for

the ER online so if there is a wait you

can wait from home instead of coming in

ER delays are a solvable

problem now I have two kids and they

hate getting blood work and in

Pediatrics we can do things to maximize

comfort and decrease pain around

procedures we can use distraction we can

use numbing cream we can even have kids

cuddle a golden retriever while they're

getting their blood work or an IV placed

and for more invasive procedures like

caiz of the bladder we can use nitrous

oxide for Sedation to make sure kids

don't have pain or a memory of that La

of that

procedure and it's not just for kids we

should think about adults too and we

should think about every way we possibly

can to decrease pain around procedures

I don't like blood work either I hate it

for me it's not so much the needle it's

tying that tourniquet around your arm

and pinching the skin that just drives

me crazy one day I was getting blood

work and I didn't feel any pain and I

turned to the FLOTUS and I said did you

use a tourniquet and she said honey for

all my patience I tie the tourniquet

around their shirt sleeve so it doesn't

pinch the skin I said I want to hug you

because you you just save me from pain

for all my future blood

draws every time we a procedure on a

patient we should offer them all the

Comfort measures we have to eliminate to

decrease pain and in healthare our job

is to think of ways to decrease pain

decrease fear decrease anxiety and

decrease suffering every chance we

can we were talking about blood draws

and has anyone ever been in the hospital

overnight and you were woken up to get a

blood

test many hospitals start collecting

their blood work at 4:00 in the morning

there are FLOTUS who troll around the

impatient Wards they collect their blood

samples and then they disappear Before

Sunrise just like

vampires why do they do that does anyone

know why they do that well in the past

it would take hours to process these

blood tests and the doctors would want

their lab results on their patients from

morning rounds but with current

technology we we can now run these blood

tests in seconds or a couple minutes

there's no longer a need to wake

patients up at 4:00 in the morning can

everyone in the room here agree that in

hospitals we're going to abandon

collecting blood work at 4

a.m. can we all agree that we're going

to let patients sleep and heal while

they're in a

hospital so we've talked a little bit

about the patient experience what about

the experience of Health Care

Professionals now burnout among

caregivers is epidemic right now and

burnout is a problem because it's a

barrier to empathy 45% of Physicians

report at least one symptom of burnout

half of Physicians would report they

would change their career in medicine

and 60% of Physicians are planning to

retire earlier than

expected the seeds of burnout are sewn

early in medical school and residency

training 75% of internal medicine

residents report burnout and what's even

more troubling is that many of them

report a lack of emotional reaction to

the death of one of their

patients it seems like our health care

culture is driving empathy out of our

young

doctors we need to restore

empathy if we can do that the weights

for appointments go away the weights in

the emergency room go

away waiting through the weekend to hear

if your child's cancer returned goes

away now it's amazing when we get this

right because when we do the comments

our patients tell us are my medical team

saved my child's life my doctor really

listened to me my nurse genuinely

cares but when we are not empathic what

do we hear I felt dismissed my doctor

seemed

rush I thought I heard some

sarcasm healthc Care Systems that are

providing an excellent patient

experience are finding they make fewer

medical mistakes their patients are more

likely to take their medications and

their patients diseases are under better

control in our Pediatric Healthcare

organization

neor we have a commitment to empathy

we're not going to rest until patient

gets the care they want and need when

and how and where they want and need

it a recent survey of Hospital CEOs

reported that improving the patient

experience was their number one priority

to work on over the next few

years we need to return to empathy can

you imagine if we redesigned the health

care system based on empathy what would

that look

like well I think we would have all the

doctors washing their hands 100% of the

time instead of the current national

average of

50% we would have two minutes of

uninterrupted time to tell our story you

could tell a good story in in two

minutes typically patients get

interrupted after 18

seconds we would be able to get an

appointment today or tomorrow we would

be able to get medical advice from our

mobile device and in the hospital the

pillars of care would be your healing

your nutrition your sleep your pain

control your communication with your

medical team you'd be given

choices and your decisions would be

would be made with your family and those

decisions would be respected and

supported I was walking out of my clinic

a few weeks ago uh and I walked into our

Hospital Lobby and I had my Hospital ID

and my stethoscope around my neck and

two parents came up to me and they said

we want to tell you about your

hospital and my first thought was to

look for security but I said okay uh

sure I'd be happy to hear what you have

to say they said we want to tell you how

much Compassionate Care our son has

received since being here this week and

we thank

you that's the kind of experience we

want for every patient every

time in

closing Sully was the type of person who

did not take no for an

answer he Challen challenged the status

quo his entire life he also jumped out

of a plane at age 60 and didn't tell his

wife but that's for a different

story he taught me to always fight for

what you believe

in I think we can agree we need to

demand the right thing for ourselves and

for our family

members let's only accept a Health Care

System that's designed to put patience

first