IS IT A QUESTION OF EMPATHY?
My daughter makes her living as
an acupuncturist, of which she is an acknowledged master, with students coming
up from New York to study with her. Some 30 years ago, when she was getting
started, she told me excitedly that the
great J.R. Worsely, with whom she had studied, was coming to New York, and that I had the opportunity to be seen by
him if I so desired. She said he was a
great master, who by feeling your pulses, hearing your voice, taking in your
odor, your complexion around the temples, and sensing your dominant inappropriate emotion, could tell almost immediately what
you were like on the inside – invaluable
information for an acupuncturist, who works with energetic imbalances. JR , as they called him, was the man who single-handedly
had brought the ancient Taoist discipline of five-element acupuncture to the
West. My daughter had told me much about
him, so naturally I was curious and looked forward to meeting him.
But when the day arrived, and the
Great Man strolled into the examination room, I took an instant dislike to him,
though to this day I don’t understand why.
He looked me over, felt my pulses and then pronounced: “You are a self-absorbed person lacking in
empathy and compassion. What’s most important to you is what you want at any
particular moment.”
I said nothing, but inwardly I
flared. How dare he? How could he,
when I had spent my life consciously struggling to be none of those things? Later,
after I had calmed down, I asked myself, could one be born with a lack of
compassion?
They say that poor people give to
charity a much greater portion of their means than do the rich. And when a poor person is braving death because
she or he can’t afford the care that would cure them, their poverty-stricken
neighbors, to help them, are far more likely to offer what little they can than would someone better off. I suppose
the reason is that having suffered hardships themselves, they know what it feels like.
But people with money have spent
their lives trying to distance themselves from exigencies of the poor. They
have their own corporate insurance, thank you very much, and the plight of the
poor is far from their minds. As they
approach the office buildings where they are employed, they resent being
importuned by beggars on the street, and they give a wide berth to the homeless
sleeping in corners or on grates. Evidence
of the poor can give a city a bad name, so considerable money is spent not so much to help the homeless, but to hide
them. To reduce the risk of having them
intrude on their peace, people with more money can choose an apartment with a
doorman, or even a gated community.
But while money and empathy seem
to exist in inverse proportions to each other, there are significant exceptions. There are some wealthy people who seem to feel the plight of the poor, and not
only write checks, but, if they’re able, set up foundations to support a pet
charity. These are moved by a variety of
factors, e.g. remembering where they
came from, wanting to “give back” to the community, or simply having an active imagination
allowing them to sense what it would feel like if they stood in a poor person’s
shoes. These people don’t need to be
persuaded to support NYHA; they have persuaded themselves.
And those with businesses big
enough to support healthcare for their workers should see the financial
advantages for themselves; they didn’t get big without a lively sense of the
bottom line.
Likewise, it should be easy to
demonstrate to lower and middle income employees that their overall expenses
should be less. When presented with the
figures, these folks should need little imagination to see the benefits to
themselves and their families.
The big challenge will be to
appeal to businesses who currently are not required to pay anything for their employees health care. Colleges need pay nothing to insure the health
of their adjunct professors, nor do real estate agents need to support the
health needs of their associates. And, of
course, small businesses who aren’t currently required to pay anything will be
very reluctant to start chipping in to NYHA.
In some of these cases, the offset of lower property taxes – which will
no longer be needed for Medicaid costs - may be enough to sweeten the bitter pill; in others, the
greater attractiveness of the state as working place may be persuasive.
But ultimately, a little bit of empathy towards those whom
high medical costs have sentenced to death, whose fate could conceivably come to
the currently more fortunate or to someone close to them – the sense that there, but by the grace of God, go they –
should be very persuasive.
Dio
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Dio
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ReplyDeleteHospitals & Health System
Thirty years ago, medical schools taught that the most important component of a mental health healing encounter is empathy, human connection, and authentic relationship between a physician and a patient.
According to the JAMA article, "Empathy in Medicine--A Neurobiological Perspective," , "lack o f empathy dehumanizes patients and shifts physicians' focus from the whole person to target organs and test results." What's more, "evidence supports the physiological benefits of empathic relationships, including better immune function, shorter post-surgery hospital stays, fewer asthma attacks, stronger placebo response, and shorter duration of colds."
The author Helen Riess, MD, goes on to describe the measurable neurobiological functions that take place between the physician and patient during an empathic encounter and shares a plethora of empirical data supporting benefits of this healing encounter.
She blames our medical education system for some of the decrease in empathy between a physician and patient and claims that much of this is due to the medical education system's emphasis on emotional detachment, clinical neutrality and an over-reliance on technology limiting human interactions.
"The... [CURRENT]... "system" continues to rely on short episodic office visits. The funding model still rewards based on production primarily. Our "innovation" of a Patient Centered Medical Home (PCMH) creating a care team consisting of a physician and extenders is still predominantly reimbursed based on production, and still does not position physicians to develop empathy, human connection, and authentic relationship with their patients and in many cases exacerbates the issue by trying to leverage rotating practitioners as a means to improve access, optimize reimbursement and lower overhead."
"The pay for performance (P4P) component of the PCMH reimbursement model is flawed as well as it is based on flawed clinical outcomes data (but that is a whole other discussion). Even the current medical education system is designed to train physicians to not honor the importance of empathy and relationship in the healing encounter."
https://www.fiercehealthcare.com/hospitals/how-a-lack-empathy-affects-our-healthcare
How a lack of empathy affects our healthcare
by Thomas Dahlborg |
Feb 8, 2011 2:06pm