Compassionomics Read online

  WHAT OTHERS ARE SAYING ABOUT THIS BOOK…

  “Trzeciak and Mazzarelli have aggregated a definitive look into how health care workers and patients alike can produce better outcomes and feel happier through adversity—all through implementing compassionate behavior. Compassionomics shows that by focusing the lens through which the brain perceives reality, lives can be changed for the better. This is a must-read for health care leaders looking to implement lasting cultural change, health care employees wanting to change patient’s lives, and consumers who need to take charge of their health care experiences.”

  — Shawn Achor, New York Times bestselling author of Big Potential and The Happiness Advantage

  “Health care must evolve from treating diseases to caring for people and their families. This is much more than a semantic difference. In the Health Transformation Alliance, our experience with more than 4 million people clearly validates what Dr. Trzeciak and Dr. Mazzarelli so eloquently argue— compassion and empathy are essential to better health care. Caregivers who practice these principles encourage people to take ownership of their health care—a result that fosters better health outcomes. I hope this book catalyzes a compassionate revolution in our health care system.”

  — Robert E. Andrews, CEO of the Health Transformation Alliance

  “In Compassionomics, Drs. Trzeciak and Mazzarelli conclusively demonstrate that the power of compassion in medicine is undeniable. Well-researched and comprehensive, the book will be a valuable tool for anyone with a desire to reestablish the primacy of compassion in health care.”

  — Rana Awdish, MD, FCCP, author of In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope

  “The health care professionals of today are constantly challenged by moral choices, whether from organizational pressure, societal expectations, or their own personal code. Under all of the mounting pressure, one constant guiding principle—to “do no harm”—drives us to do whatever we can for the benefit of the patient. Compassionomics provides the evidence that one simple tool, compassion, can affect not only the outcomes for our patients, but also the financial health of our organizations and the well-being of our providers.”

  — Donald M. Berwick, MD, MPP, president emeritus and senior fellow of the Institute for Healthcare Improvement and former administrator of the Centers for Medicare and Medicaid Services

  “It is easy for hospitals—and thereby physicians—to believe that focusing on volume, rather than quality, will drive results. No one, however, comes into healthcare with this idea in mind; it is a byproduct of an age where systems are stretched thin on time, talent, and resources. Physicians want— and need—to practice in environments that emphasize focus on outcomes and experience. They want—and need—to know that their work makes a difference. With meticulous research, Compassionomics blends these ideas— that physicians can feel proud about their work and produce high-quality outcomes for patients. By focusing on compassionate care, Drs. Trzeciak and Mazzarelli provide a simple, but effective, roadmap toward positively affecting both physician burnout and patient engagement. Compassionomics can help restore the hope for everyone in health care that they can have a positive, meaningful career that is driven by human connection, not numbers.”

  — Robert Bessler, MD, founder, chairman and CEO of Sound Physicians

  “Today, in these challenging times, we often bear the burden of the pace of change and complexity of care. This book offers so many ways to think about compassion: for patients and families, for your team and colleagues, and for yourself. I can’t think of a more important path than compassion to get to the Institute for Healthcare Improvement’s Triple Aim—better health, better and safer care, and lower costs. This is the best book I’ve read in years.”

  — Maureen Bisognano, president emerita and senior fellow of the Institute for Healthcare Improvement

  “The foundation for providing sustainable, quality care is simple: compassion. If we want to keep healthy people out of hospitals, support the most vulnerable of patients or those with long-term issues, and lower health care costs, compassion must be at the heart of all these interactions. Drs. Trzeciak and Mazzarrelli’s deep dive into the data that support this fact is second to none. In Compassionomics, they have built the thorough and inspiring case for anyone who wasn’t already convinced that compassion was essential to health care and empowered those who are firm believers.”

  — Jeffrey Brenner, MD, senior vice president of integrated health and human services at UnitedHealthcare Community & State and MacArthur Fellow

  “It goes without saying that compassion is a crucial element for healers and healing. Except that we don’t have enough emphasis on compassion in today’s health care system. This dearth of compassion in training and practice makes Compassionomics timely, important, and vital. Whether you are a clinician, administrator, or a health care patient (i.e., all of us), its message is a call to action for true change in the way we deliver and receive care.”

  — Arthur Caplan, PhD, Drs. William F. and Virginia Connolly Mitty professor and head of the Division of Medical Ethics at the NYU School of Medicine

  “Hope is central to progress in health care. And hope is a byproduct of compassion. In Compassionomics, Drs. Trzeciak and Mazzarelli provide not only compelling evidence of how simple acts of compassion positively affect patient outcomes, but they also demonstrate that compassionate care improves the experience of those who work in healthcare. Instilling compassion throughout the delivery of health care will enable the health care industry to advance into the future.”

  — David L. Cohen, businessman, attorney, and chairman of the board of trustees of the University of Pennsylvania

  “This well-researched book on such an important topic will be welcome news to all those who strive daily in the front lines of health care provision. They know well the importance of compassion and its effect on outcomes and overall well-being—not just for patients but for the providers themselves. With it we win, without it we struggle. This is also a directive to leaders to include compassion as a key criteria in recruitment and promotion. My congratulations to the authors for bringing it center stage.”

  — Michael J. Dowling, president and CEO of Northwell Health

  “My mentor for compassionate care was my physician father, the co-founder of HCA Healthcare. As he frequently said, ‘It’s not bricks and mortar and equipment that make a hospital. It is the warmth and compassion and attitude of good employees that leads to quality care.’ Trzeciak and Mazzarelli’s findings not only provide us with data to show how compassionate care achieves measurable improvement to patient outcomes, but also shows gains in fiscal health and employee satisfaction. Those of us in health care owe it to our patients to review the facts, implement the solutions, and make the essential personal connections that can change health. This book is a vital step forward in transforming health care as we know it.”

  — Senator William H. Frist, MD, heart transplant surgeon and former Republican Senate majority leader

  “Compassionomics is a very important book for everyone engaged in health care, including physicians and nurses, health care administrators, educators, and especially patients and their families. It documents the impressive and growing evidence base that supports the critical role that compassionate care plays in shaping outcomes in clinical practice. From ancient times, scholars have described both the ‘art’ and the ‘science’ of the practice of medicine. Compassionomics presents a wonderful distillation of the science behind the art of a healing and health-promoting doctor-patient relationship.”

  — Robert N. Golden, MD, dean of the School of Medicine and Public Health and vice chancellor for medical affa
irs at the University of Wisconsin-Madison

  “We work so hard to master diagnosis and therapeutics that it’s easy to forget that all patients get better faster if they receive compassionate care, as marvelously laid out by Trzeciak and Mazzarelli. However, it’s as true for us physicians as it is for our patients: friends are the best medicine, and isolation kills. This isn’t a ‘self-improvement’ book, but we should all read it, because we’ll all find in this book a path to feeling better.”

  — Stephen Klasko, MD, president and CEO of Thomas Jefferson University and Jefferson Health

  “Drs. Trzeciak and Mazzarelli’s proclamation acknowledging the power of courageous caring, now rooted in quantified science, is so timely and essential in the inevitable transition to a consumer-focused healthcare system. This book is a must-read for health care providers—indeed, a blueprint for a high-performance culture.”

  — Calvin H. Knowlton, BSc Pharm, MDiv, PhD, chairman, CEO, and founder of Tabula Rasa Healthcare, Inc.

  “A wonderful, evidence-based book that is a must-read for the health professions—if not every citizen-patient—especially, the leaders of health care. Drs. Trzeciak and Mazzarelli show, in no uncertain terms, that health systems that fail to embrace and prioritize compassion are missing out on caring fully for their patients and for their clinicians and employees. As the Gold Foundation has championed for 30 years, compassion makes a dramatic, measurable difference in health care—and this book proves it.”

  — Richard I. Levin, MD, president and CEO of the Arnold P. Gold Foundation

  “If you’ve ever been a hospital patient, you know that compassion on the part of the caregivers is perhaps the single most important factor affecting your experience. The medical profession, somehow, has failed to see this. It took Drs. Trzeciak and Mazzarelli to make this incredibly important and long overdue observation on compassion. Let’s hope this book is the basis of a revolution on health care.”

  — Steven Levitt, New York Times bestselling author of Freakonomics

  “If you or a loved one has ever been ill or worried about your health and have had the good fortune of being cared for by a compassionate health care professional, you probably don’t need to be told that compassion matters…a lot. And if you are a health care professional who has been able to offer your care and compassion to those who are ill and vulnerable, you certainly don’t need to be told that a sense of connection through compassion is what rewards and sustains you.

  So why does compassion remain on the sidelines as ‘nice,’ but not absolutely essential, in the ways we train health care professionals and teams and in how we deliver care and evaluate health care organizations and systems? Drs. Trzeciak and Mazzarelli are trying to rectify this. By sharing stories about illness alongside highly readable summaries of decades of scientific research, they make a compelling case that compassion is vital to our collective health and well-being. Perhaps heightened public and professional awareness of the value and importance of compassion will enable us to raise our voices together to insist that compassion is a necessity, not a luxury, in health care.”

  — Beth A. Lown, MD, associate professor of medicine at Harvard Medical School and chief medical officer at the Schwartz Center for Compassionate Healthcare

  “Research has long shown that the kind and caring gesture of a health care provider can have significant beneficial effects on a patient’s health—yet medicine often operates like compassion doesn’t matter. We now finally have a book on this fascinating topic that will empower patients to choose providers with a heart. Thank you, Drs. Trzeciak and Mazzarelli, for helping shape medicine’s future for the better.”

  — Emma Seppälä, PhD, science director of the Center for Compassion and Altruism Research and Education at Stanford University and author of The Happiness Track

  “At a time when precision medicine has the potential to make the ‘art of medicine’ obsolete, this book demonstrates that the power of healing lies not just in our genome, but also in our soul. Through their journey and scientific explorations, Trzeciak and Mazzarelli remind professionals and patients alike what is truly important and offer a formula for improving health care, one patient at a time.”

  — David Shulkin, MD, ninth secretary of the Department of Veterans Affairs

  “Every patient welcomes the emotional comfort afforded by a health care practitioner with a good bedside manner, but now comes evidence that compassion from caregivers isn’t only proper and just—it actually saves patient lives. This book is eye-opening—between the data and the stories that bring the data to life—for those that provide care as well as those that receive care, which makes it a great read for everyone.”

  — Michael Smerconish, author, columnist, and host of SiriusXM’s The Michael Smerconish Program and CNN’s Smerconish

  “In the dawning of the compassion-centric paradigm of medicine with the new cutting-edge science of compassion, we have been in need of someone to evaluate the hundreds of studies we already have that demonstrate how compassion in medicine positively affects medical outcomes, patient experience, business profitability, and even the well-being of clinicians themselves. Trzeciak and Mazzarelli have done a thorough systematic review of all the studies to date that address the hypothesis that ‘compassion matters.’ They have given us the gift of a very insightful and concise summary of this work and related it to what we do practically every day. Clinicians will feel a validation of their call and their intuition that compassion really does matter. Compassionomics provides the scientific evidence that anyone who practices medicine without compassion is scientifically outdated and committing malpractice.”

  — Dominic O. Vachon, MDiv, PhD, director of the Ruth M. Hillebrand Center for Compassionate Care in Medicine at the University of Notre Dame

  Copyright © 2019 Studer Group, LLC

  All rights reserved.

  Published by:

  Studer Group

  350 West Cedar Street, Suite 300

  Pensacola, FL 32502

  Phone: 866-354-3473

  Fax: 850-332-5117

  www.studergroup.com

  ISBN: 978-1622181063

  Library of Congress Control Number: 2018968569

  This book was published by Studer Group Publishing, the exclusive publisher for Studer Group. Studer Group, a Huron solution, works with healthcare organizations to help them achieve and sustain exceptional improvement in clinical outcomes and financial results.

  The stories in this book are true. However, some names and identifying details have been changed to protect the privacy of all concerned. Any reference in this publication to any person or organization; activities, products or services related to any named person or organization; or any political party, platform, or candidate, do not constitute or imply the endorsement, recommendation, or favoring of The Studer Group, L.L.C., its affiliates, or any employees or contractors acting on their behalf.

  All rights reserved. No part of this book may be used or reproduced in any form or by any means, or stored in a database or retrieval system without the prior written permission of the publisher, except in the case of brief quotations embodied in critical articles or reviews. Making copies of any part of this book for any purpose other than your own personal use is a violation of United States copyright laws. Entering any of the contents into a computer for mailing list or database purposes is strictly prohibited unless written authorization is obtained from Studer Group.

  Printed in the United States of America

  This book is dedicated to all of the nurses we have

  ever worked with and that we continue to work with.

  Your compassion for patients has saved many a life

  and has inspired us to be better doctors.

  CONTENTS

  Foreword

  Preface—An Explanatory Note on the Origins of this Book

  Introduction

  Part 1—The Case for Compassion

  Chapter 1: The Compassion Crisis
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br />   Chapter 2: Does Compassion Matter?

  Part 2—Compassion Improves Outcomes for Patients

  Chapter 3: The Physiological Health Benefits of Compassion

  Chapter 4: The Psychological Health Benefits of Compassion

  Chapter 5: Compassion Motivates Patient Self-Care

  Chapter 6: Compassion is Vital for Health Care Quality

  Part 3—Beyond Patients

  Chapter 7: Compassion Drives Revenue and Cuts Costs

  Chapter 8: The Power of 40 Seconds

  Chapter 9: Nature v. Nurture: Can We Learn Compassion?

  Chapter 10: Compassion as an Antidote to Burnout

  Conclusion—Compassion Matters

  Acknowledgments

  References

  About the Authors

  FOREWORD:

  We are often led to believe that sentiments like compassion, love and kindness are expressions of weakness rather than signs of strength. And we are often all too ready to give in to the false belief that meanness somehow equates to toughness and that empathy is empty of power.

  But the evidence—in our shared history as Americans and here in this book—suggests the opposite.

  Our country was founded on the understanding that if we were going to make it, we would need to make an unusual commitment to one another. To be clear, our founders were imperfect people, and our founding documents are saturated with examples of bigotry and sexism, but these imperfect individuals succeeded in putting forward a more perfect ideal. When our founders wrote, “we mutually pledge to each other, our lives, our fortunes, and our sacred honor,” as the last line of our Declaration of Independence, they were also declaring our interdependence. They were declaring that our destiny as Americans would always be indivisible.