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

This talk was given at a local TEDx event, produced independently of the TED Conferences. Paul Rosen, MD, a pediatric rheumatologist, serves as the Clinical Director of Service and Operational Excellence at Nemours. He received a masters of public health degree from Harvard University and a masters of medical management degree from Carnegie Mellon University. He was named ‘One of the First 100 Innovators’ by the U.S Federal Government Agency for Healthcare Research and Quality. Dr. Rosen’s interests include patient-physician communication, family-centered care, and the patient experience. He teaches medical students about improving the patient experience, and he serves as the faculty mentor for the physician executive leadership program for medical students at Jefferson Medical College. He is also a volunteer faculty member at University of Central Florida College of Medicine.

Paul Rosen, MD, a pediatric rheumatologist, serves as the Clinical Director of Service and Operational Excellence at Nemours. He received a masters of public health degree from Harvard University and a masters of medical management degree from Carnegie Mellon University. He was named ‘One of the First 100 Innovators’ by the U.S Federal Government Agency for Healthcare Research and Quality. Dr. Rosen’s interests include patient-physician communication, family-centered care, and the patient experience. He teaches medical students about improving the patient experience, and he serves as the faculty mentor for the physician executive leadership program for medical students at Jefferson Medical College. He is also a volunteer faculty member at University of Central Florida College of Medicine.

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[donnahayes]

We need to take care of our health care workers and empathy will come back. We need lunch breaks and coffee breaks during a 12 hr shift. It renews us to continue to take care of our patients.

[kristyschmidt]

Thank you, even 7 years later more relevant than ever. Empathy Revolution for Healthcare!

[AngelCruz]

Dr. Rosen did a very good job putting into perspective the idea of treating patients as people and health care providers having empathy towards patients. It makes me think of times where I was in a similar situation where your needs as a patient aren’t put first. Empathy is a critical component of healthcare, and it is essential for doctors to exhibit empathy in their interactions with patients. I feel empathy involves the ability to understand and share the feelings of patients, which includes cases like Dr. Rosen’s father-in-law. Empathy is a vital aspect of effective communication and patient care. He brings up a great point of the jobs of healthcare providers should be to decrease pain, fear, suffering and anxiety when treating a patient. When doctors demonstrate empathy, they can understand their patients’ concerns and provide the emotional support that is often needed during medical treatment. Dr. Rosen mentions how burn out can be a barrier to empathy and many healthcare providers report feeling burn out which is something concerning to hear. This burn out affects how physicians react to the needs of their patients. Finding different ways to lessen burn out and apply more empathy with patients will go a long way for healthcare. This will allow physicians to make fewer medical mistakes and have better control of a patient’s disease, as Dr. Rosen stated. Overall, empathy is a crucial component of healthcare, and it is essential for doctors to exhibit empathy in their interactions with patients. This can lead to improved health outcomes and greater patient satisfaction.

[melissahall]

Good points & I am an RN and have seen much of this & feel it needs fixed. It is very sad. We need to take care of our nurses so nurses will not be burnt out. I had to move to CA to join unions because I was about to quit nursing because of the awful conditions. No breaks for 13 hours, overload & unsafe assignments, and being bullied by Drs who feel like it’s ok to call nurses morons, idiots, yell at you & hang up simply for calling with a patient need, etc, anytime they feel like it & not be held accountable by admin. I’ve even worked around a Dr who was written up for stating he’d like to “line the nurses up & shoot them.” The system needs fixed... more empathy, respect & holism. Just as if you take care of yourself as a parent you become a better parent... we need to truly look at taking care of our nurses. Conditions are better in CA but we have 49 more states to deal with this. I truly believe admins will not fix this without ratio laws in all states.

[HCSuccess]

Paul, you are awesome. Thanks for attending our seminar this weekend, and thanks for being such a great contributor to our blog!

[MedschoolMom]

Thank you Dr. Rosen for sharing the story of your father’s hospitalization. His experience is far too common in our current healthcare system. It's our ethical obligation as physicians and healthcare leaders to give the best care possible. As Dr. Rosen emphasized, it’s our ethical obligation to “decrease pain, fear, anxiety, and suffering every chance we can.” In many instances we are failing at that charge. The healthcare system in general is designed much more for the convenience of the providers and the insurance companies than for the patients. Dr. Rosen’s example of the phlebotomists waking patients at 4 a.m. to take their blood is a perfect illustration. Clearly being awakened at such an early hour isn’t convenient for the patient, and interrupting their sleep may actually be detrimental to their recovery. You could say it’s a violation of our oath to “do no harm.”
I also appreciate Dr. Rosen’s prescription for an increase in empathy. As a medical student, I can attest the outrageous requirements of medical school and residency can certainly lead to early burnout and the driving out of empathy. I’m sure the challenges will only amplify after I complete my training. If we agree failing to treat patients with empathy and compassion is unethical, then creating an environment that pushes physicians to the point of burnout and pushing them to lose empathy is also unethical. We need to make it ok for doctors to care. We need to facilitate empathy. Failing to do so is harming patients.

[sr]

Dr. Paul Rosen addresses amazing points during his speech. I think implementing small changes in the healthcare industry will certainly improve the doctor-patient relationship.

[nickslaboden]

I would like to start by saying thank you to Mr. Rosen for sharing your knowledge with us. Your perspective on healthcare is exactly what healthcare should be all about. I am a medical student and you are right, I am concerned that empathy is being sucked out of the patient experience. While this is due to a plethora of reasons, it needs to be addressed more heavily. In my advanced ethics course we talk about beneficence, which means to promote the most good. How can we as healthcare workers promote the most good if we are not even good ourselves? We “know” through study after study that listening to your patient is the best way to treat them and build trust, yet we fail to do that. You mention this in your talking point about what would an empathetic healthcare model would look like if we listened for two minutes versus interrupting every 18 seconds.
We as healthcare providers work alongside the body to help it heal. We do not do the healing alone. So on the topic of beneficence, it would make the most logical sense to assist the patient by listening to them and lending a more empathetic ear instead of treating the patient like how Mr. Rosen’s dad put it, “like a piece of meat”. There is a strong psychosomatic axis that could theoretically advance the healing process if the patient felt believed, accepted, and even loved. This is what promoting the most good looks like in my mind.
Mr. Rosan’s story about the phlebotomist addressing more sensitive techniques for patients was another crucial point. So many patients hate the repetitive treatments that the diagnostic process requires. A good example is radiation treatments patients having to be in the machine for so long. It freaks so many of them out. What if there was a way to block out the noise instead of giving them the lowest quality headphones. What if we could minimize the claustrophobia they experience? This is the direction that healthcare needs to be going and it is not. To close this comment, I want to say thank you again to Mr. Rosen, this was a powerful speech in such a short time. Thank you for reading.

[SomeGuy-pk]

Having spent considerable time in and out of hospitals, I can't stress enough how important empathy is, and I’m so glad Dr. Rosen bought this up. Being ill can be incredibly lonely and frightening, and being met with apathy can almost be too much to take sometimes. On the other hand, a little bit of empathy on the part of healthcare workers goes a long way. I recall many times when a nurse or doctor has gone out of their way to see me and engage with me. It meant a lot, then and now. Many times my mood was lifted and it saved me from feelings of despair. I’ve also spent a lot of time waiting in the ER due to rooms not being available. I’m glad to hear work is being done to streamline this. If you're going to the emergency department, you want to see a doctor as soon as possible, and if the waiting can't be helped, it would be better to wait at home and come in when you don't have to wait long. This is especially crucial for immune compromised patients (as was my case), since spending hours in the waiting area can be leave them unnecessarily vulnerable to infection.
I'm now in medical school, and as a future doctor I am thankful for this talk and all the practical tips I can implement in my practice.
I also agree with the statement regarding the rigorous schedule of medical school and it’s affects emotionally on students. This is something I’ve seen in myself and my classmates. Most of us decided to become physicians out of a desire to help others, but between the mentally and emotionally exhausting nature of the program, and seeing countless diseases presented as hypothetical vignettes, it's easy to get a bit jaded. Fortunately, at least in my circle of friends, we make a habit of encouraging and reminding each other why we're doing this. As the principle of beneficence dictates, we should always strive to do right by our patients, and part of this means being empathetic. We need to remember that each patient is a person, and not just a case. I want to make sure my heart is still in it. Thank you for sharing.

[AriaZar-pv]

Dr. Paul Rosen uses such a personal anecdote in his portrayal of the lack of empathy in healthcare. My mind immediately went to another TED talk I listened to my Dr. Anthony Orsini, in which he explained the lack of humanity in healthcare practice, to which I attributed some level of extreme desensitization amongst providers towards patients. Dr. Rosen emphasizes how newly renovated and updates hospitals are created with the intention of tending to physician’s needs, rather than the patient’s. With an emphasis on how far medical technology and education has come, the lack of empathy in scheduling patient’s appointments due to constraints, no introductions or explanations between patient handoffs in hospital settings, and forgetting the very normal human emotions of fear and frustration between extensive triage times, all impact the way that healthcare providers don’t demonstrate complete care of patients. Often times, patients can have very few memories of ED or hospital settings and having negative experiences even just once might leave long lasting portrayal of a negative memory, but also create a sense of resentment in patients who are having to constantly experience the lack of humanity and empathy in such a sensitive and critical setting.

[LunaStone-zp]

Dr. Paul Rosen, a pediatrician, does an excellent job of bringing the ‘why’ back to healthcare. As he speaks about empathy as the essential thing to prioritize while treating patients, I, as a second-year medical student, am reminded that on the other side of all of this studying and training, there will be a patient I can eventually help. And while being proficient in my studies is incredibly important, what is most important is that I address each patient with empathy and compassion. Without empathy and compassion towards patients, all the knowledge and information I have learned to help people may not even benefit them. Especially in today’s healthcare system, it is easy to get lost in the fast-paced, money-driven corporate world that emphasizes numbers and procedures over quality time with patients. In his talk, Dr. Rosen talks about his father-in-law’s experience at one of the biggest hospitals on the east coast. His father-in-law felt that he was being treated as a ‘piece of meat, ’ being carted from one room to the following, one scan to the next, without the staff acknowledging him, only talking amongst themselves. From personal experience, I know that these are not isolated scenarios.

My father was hospitalized last Thanksgiving for a complication of chemotherapy treatment. The staff was impersonal at best, and no one was available to answer our questions because it was the holidays. My dad ended up getting discharged several days later than he should have. It felt like the staff had forgotten that my dad was a person too, who would have loved to have been able to spend Thanksgiving at home with his family as well. Dr. Rosen also quoted Henry Ford as Ford toured Henry Ford Hospital after it opened. Ford said, “I see you have designed the hospital perfectly to fit the needs of the physicians but not the patients.” This is not to discount the importance of acknowledging the needs of physicians. Physicians are dissatisfied with their experiences at the hospital as well. Rosen further stated that 45% of physicians report at least one symptoms of burnout, 50% of physicians said they would change their career in medicine, and 60% of physicians plan to retire earlier than expected. Both the physicians and the patients appear dissatisfied with their healthcare experiences. What do we do to change this? Dr. Rosen suggests empathy is the cure, and I couldn’t agree more. In medical ethics, the principle of beneficence requires physicians to provide the best healthcare possible to their patients. This not only means running the proper diagnostic tests and performing the correct procedures but also incorporating how we interact with patients–expressing empathy constantly. It would be amazing to see physician and patient satisfaction changes if we all began prioritizing empathy in our healthcare settings.

[daviddivineful]

I have worked on the administrative side and handled complaints many, many times. Part of my job. One of the biggest obstacles was empathy and the desire to spend a few minutes more helping the patient. Now, I am in a nursing program. My strongest attributed? Compassion and empathy intertwined with experience and intelligence. Dr. Rosen is so right about empathy. I wish more people felt like he did. We tend to forget what it is like to be a patient. I did and had my "aha moment" when I was a patient in the ED. I told myself I will never be that way again and I have not. I plan on working in geriatrics. Love working with older adults. God's Calling. Glad I watched this video. It reaffirms me beliefs.

[wellbodisalone]

Empathy is a crucial component when providing healthcare services. Understanding the feelings of others, including patients, their families, and other healthcare providers will drive toward a positive healthcare environment.

[ciaragalley]

Patient satisfaction and patient interaction I believe is one of the most important attributes of health care. Health care is specific to each patient, and each patient should feel as though their visit is specific to them. When Dr. Rosen said that his father-in-law felt he wasn't being treated as a person, that is something I think all of us can relate to when it comes to visiting the doctor. It is important for medical professionals to explain to the patients what is being done, and what the information they find out means. It is also important that medical staff at very least, act as if they are in a good mood. When someone is at a hospital receiving medical care, they are probably feeling down on themselves already, and something as simple as medical professionals flashing a smile could improve their mood. Overlooking patients and their needs means something is broken, as Dr. Rosen said. Health care is more suited to the physician rather than the patient, like Dr. Rosen said. I understand that doctors are very busy and being pulled in many different directions, but health care should always put their patients first and consider what the patients need. Time has always been an issue with health care for us, and while many are trying to fix these issues, many are also not. Dr. Rosen said every procedure in health care, they should try and make patient's as comfortable as possible. This is very important to me, and every other patient I think. Empathy for patients and their care is of up-most importance in health care, and it could allow patients a better experience when it comes to dealing with their health issues.

[blessedtrinity]

Compassion and honesty to work with people. Thank you for the hope I am saddened that the Judge voted down health care workers doing what their heart is telling them to do.

[susanarmstrong]

I was in the hospital for a few days recently and hated the way some seniors were treated. One older lady needed a walker and was on intravenous, so she needed to be helped to the washroom every hr. or more. She rang her bell and was neglected at times for 30 min. at times and the nurse was so upset if her diaper needed to be replaced. The nurse yelled at her when asked what took her so long to arrive and said: " you are not my only patient I have 6 people that all need my attention". I am aware they are short staffed, but that comment was not needed. When I was able I helped this poor, scared lady how ever I could.

[elik]

I strongly agree with Dr. Paul Rosen’s statements regarding the need for empathy in healthcare, and sympathize entirely with the way his father-in-law was treated in the hospital. Recently, I sustained an ankle injury which was first diagnosed as a sprain. After an unimpressive x-ray, I was sent home with a compression Acewrap. However, 8 weeks later I was still having pain, so I saw a different doctor, who ordered an MRI, which showed that I had 1.5 torn ligaments. I was referred to a podiatrist to determine if I needed surgery, and it was that visit that really illustrated the lack of empathy in the healthcare system. I waited almost an hour after my scheduled appointment time with the podiatrist because he was running behind. When I finally met him, he told me the requirement for surgery was 2 torn ligaments, so I didn’t need it, advised I continue the Acewrap, and see him again in 3-4 weeks. I was ushered out so quickly that I didn’t have a chance to formulate any questions, and before I knew it, was driving home, pain still present in my ankle. The podiatrist made me feel so irrelevant that I went back to my primary and demanded a second opinion. It is because of this that I believe empathy is an essential characteristic of all healthcare professionals.
I also think empathy is critical in the healthcare environment because in order for a physician to provide the best care, he or she needs to have an understanding of the patient’s physical, spiritual, and emotional wellbeing. Having that holistic approach and showing compassion towards the patient opens doors in terms of patient satisfaction and healing. Dr. Kate Lindemann of Mount Saint Mary College has concluded that there are three stages of empathy. Zero empathy being that the “decision maker may follow moral rules or work for good consequences, but s/he has no empathetic understanding of the Other”, and the third degree of empathy being that the “decision maker has developed her/his capacity for attention to the degree that the decision maker can attend to the Other so fully as to see what the situation means to the Other…and treats the Other in accord with the Other’s meaning and desire”. The first and second degrees lie in between the two aforementioned definitions. Ethically, physicians are bound by the principle of non-maleficence, meaning they must first and foremost do no harm to the patient. Intertwining that third degree empathetic component with every patient visit can help the physician better understand what the patient needs, desires, and is willing to agree to. This will help the physician meet the other ethical principles of beneficence, autonomy, and justice more easily because the physician has a better understanding of the patient overall.

[baileyschnell]

Paul Rosen states a very good case,  as I agree with him in his topic of empathy towards patients in the health care systems. It's not fair to state that all doctors and individuals in the medical field have lost concern for their patients and don't worry about how well they are cared for, because there is of course some medical professionals left that do show true empathy towards each patient and attend to their every need while they're there. But, I do agree with Paul that the list of these people has very much decreased and often hard to find a quality nurses in hospitals that will actually seem to truly care about you as a patient. It's very common to hear stories where patients felt that not anyone seemed to want to provide the best possible care, which is a huge problem in healthcare today. I agree that it's also especially important in dealing with elderly and children as that children will be harder to be treated if they feel uncared for. Although I feel that Paul makes many strong remarks throughout the talk, I have to disagree with the point that even though it was more in the past than today, to let patients sleep instead of waking them up during the night for blood, checkups, etc. and let them rest. Even though there may be times where it is preventable, these things often need to be done at certain times and can't put the medical professional at fault. Other than that, I feel strongly towards the issue of empathy as that is something that needs to be addressed and practiced more with each and every patient.

[maiyshawkat]

I totally agree ! But let's also agree on a healthcare system that won't lead doctors to burn out! And don't forget that doctors are humans too! If we reached that point first, then empathy can be restored with no time !

[EthicsCommentary]

Dr. Rosen provides a glimpse of how important and necessary empathy is within physicians and healthcare systems. I imagine many of the issues Dr. Rosen discusses have only intensified or grown exponentially since COVID (as this talk occurred in 2014). Additionally, I concur that physicians lose empathy as they progress through their 8+ years of brutal medical training. However, Dr. Rosen does not provide many reasons as to why physicians are burned out within the current healthcare system or courses of action in reforming the current healthcare system. Dr. Rosen focuses primarily on patients advocating for themselves. However, I would like to focus on the consequences of what happens when physicians lose empathy and healthcare systems do not take care of their physicians. Medical ethics principles dictate that physicians are to uphold beneficence, non-maleficence, justice, and patient autonomy. However, I feel those principles, particularly beneficence and non-maleficence, may come into jeopardy when a physician becomes burned out. A study from JAMA in 2020 demonstrated that physicians are prone to more medical errors from burnout. If the system the physicians are working for or employed by are not taking measures to assist physicians in counteracting burnout before it sets in, then medical errors will result. Therefore, beneficence or a physician’s ability to provide the best care for his/her patient and maleficence or doing no harm to the patient will be thwarted. I concur wholeheartedly with Dr. Rosen that all patients should be treated with empathy; however, there are many barriers within the current U.S. healthcare system that practically bar physicians from being able to practice medicine the way they had intended to, with the utmost care, respect, and empathy to their patients. Until health care system reform happens on a macroscopic scale where physicians’ administrative duties or patient workload is decreased, I am unable to visualize how patients’ demanding for empathy is going to revolutionize the current healthcare crisis in reducing physician burnout or increasing physicians’ levels of empathy.