Fifty-six percent of all Americans own a smart phone. The term nomophobia has been coined and accepted into our lexicon to describe the fear and rush of anxiety that may accompany some when being without their phone. Computer users report an average of 66 hours per week staring at their monitor. One in eight people are addicted to the internet.
Since the advent of iPhones and MacBooks, people have grown tethered to their smart phone screens and laptop monitors, while at the same time human affection and connection has decreased in all walks of life. The health care profession is no different.
“[The thing that health care needs to change the most] is the understanding of the significance of the loss of compassion and empathy in the entire spectrum of health enterprises,” said President and CEO of the Arnold P. Gold Foundation Richard Levin.
The clinician-patient must be maximized to enhance the hospital visit experience to its fullest potential.
“In every health encounter—institutional, ambulatory care, it doesn’t matter,” Levin said. “The availability of technologies that actually make a difference over the course of an illness, and the acceptance by clinicians of the need to be efficient, to follow the value equation—which is value equals quality over dollars—has caused us to lose sight of the fact that this began and must remain a human interaction between clinician and patient.”
Levin believes two factors, keeping the importance technology in perspective and responsibility of hospital leadership, can ensure that human interaction remains paramount in health care.
Deemphasizing Technology in the Patient Experience
The prominence of technology in protocol and procedures has increased since 1819, while the importance of human contact has been on the decline.
“Technology is actually neutral,” Levin said. “It’s neither a good nor bad thing. It’s how it’s used, and whether we’re aware of its potential to move us way from the critical challenge, which is to reestablish contact. We began to lose it curiously, paradoxically with [René] Laennec’s invention of the stethoscope.”
Physician visits were a much more intimate experience.
“In order to listen to the wheezing of a person with asthma or the burbling of someone with pneumonia, you had to put your ear on the patient’s chest,” Levin said. “With the invention of the stethoscope, which amplified the sound, it moved the doctor away from the patient physically. In many ways, we’ve been on that pathway now for over 200 years.”
Levin’s aim is to arm medical students with a well-rounded knowledge and comprehension of humanity early in their educational track in lieu of guidance on how to use the latest gadgets.
“We need to change the nature of health professions education so that the conversations about these very difficult, complex, basic problems in human existence can be understood before our students hit the first wall of transition, which is from studying biology to taking a pulse, meeting a patient, being in the hurly-burly world of the academic medical center,” Levin said.
“And [we need] to get the student involved to understand how strong the pull will be of what academics refer to as the hidden curriculum, the curriculum that is the process of being socialized into becoming a practicing physician.”
It starts at the top. Levin believes an open dialogue with thought leaders across the industry regarding the increase of human compassion in hospitals and research institutions is a necessary component of the development of the health care system.
“And the second thing is an understanding by the top of the chain in what have become hospital city-states—remarkable organizations that have extraordinary power in local or huge geographies,” Levin said. “There must be a recognition that in that value equation is this fundamental human value that will in fact result, not only in a better bottom line, but in the salvation of health care in the United States. And encouraging the conversation will allow us to move back to the future.”
Levin predicts that backtracking to a more human-oriented emphasis during treatment will be essential.
“The concern is that we have allowed a system to develop– and that’s an active thing we did—which seems to fail to recognize the value of this most fundamental of the core elements of scientifically excellent practice,” Levin said. “I think it will be fine, but we do need to go through this process of recovery.”
Overall, Levin has mixed views of the future of health care.
“I’m hopeful and frightened,” Levin said. “I’m hopeful because touring around the entire country, interviewing medical students about this perspective humanism and medicine, they are as good, as turned on, as engaged, as hopeful, as any group of medical students in my lifetime. So that’s fantastic. If anything, the system is encouraging a group of people who could be humanist in practice.
Ultimately, patients need to feel that they’re in a safe harbor in order to be completely open, to be truthful, to be intimate, to be accepted by another human being whose sole purpose in being there is taking care of that individual. Research has shown that compassionate care improves health outcomes.”
If the health care field is able to revert back to an emphasis on human connection that was prevalent before Laennec’s invention of the stethoscope, physicians will be listening in to much more fulfilled hearts.