Compassionate healthcare expands empathy and combats burnout

The Schwartz Center for Compassionate Care is a national nonprofit dedicated to helping healthcare organizations foster a compassionate culture that supports both patients and caregivers. Health systems that partner with the Schwartz Center report improved teamwork and collegiality among care teams, and reduced feelings of stress and isolation from their physicians.

Those findings dovetail with ongoing research by athenahealth showing that highly “capable" organizations — defined as those that give physicians the latitude, tools, and resources to care for their patients — have physicians who are twice as satisfied, two-thirds more loyal, 36% less burned out, and 10% more productive.

With those alignments in mind, athenaInsight spoke recently with Beth Lown, M.D., the Schwartz Center's chief medical officer, to discuss ways that compassionate care and capability can intersect to address physician burnout, isolation, and stress.

Q - Our research shows that leadership and communication are far and away the most important drivers of physician loyalty and engagement — more than twice as important as compensation in keeping physicians from leaving their jobs. How does leadership create a culture of compassion and communication?

Leadership really sets the tone, the cultural norms, and the expectations for middle management, which then set the climate in the clinics or on the wards. So, it's crucial that it comes from the top of the organization. Increasingly, we're finding that's where requests for our services [are originating].

Q - Your center pioneered Schwartz Rounds, a regularly scheduled time for healthcare workers to openly and honestly discuss the social and emotional issues they face in caring for patients and families. How do Schwartz Rounds help with building this culture of capability and caring?

Schwartz Rounds offers the opportunity for empathy in community through communication. Some of it's through perspective-taking. Some of it is through personal sharing, recalling memories, recalling common experiences about things that happen in the everyday care of patients and their families.

To the extent that the information [shared by providers] is received by leaders and managers, it's going to co-construct a culture of caring and compassion. [It builds] authentic compassion and caring at a leadership level for the people they oversee. For leadership, having an understanding of who your people are outside of [the traditional] “town-hall"-style meeting, that goes a long way.

Q - Our data show physicians in highly capable organizations, where providers have what they need to care for patients, are 36% less likely to report symptoms of burnout. How important is it to think of burnout as an organizational responsibility rather than as an individual failing?

Extremely important. Burnout is a reflection of the interaction of personal and organizational resources, how a physician's support structures and personal resiliency intersect with their professional role.

There is starting to be a lot of pushback about burnout being perceived as an individual failure — like, “you're just not strong enough." If you really want to support clinicians, providers, and staff, you need to create an environment in which they feel connected, in which they have a sense of purpose. That's very different than saying, “Go take a yoga class or meditate." Burnout is really an occupational syndrome.

Q - athenahealth's research has found that physicians who report feeling isolated even a few times a week are almost twice as likely to experience burnout as their colleagues who only feel isolated once a month. Does it surprise you to learn that isolation dwarfs all other factors as a driver of physician burnout?

Not at all. We have looked at the impact of our Schwartz Rounds program on several domains of care and physician well-being. One was isolation, a sense of stress, feeling alone in your work. We found a dose-effect response among caregivers who attended the rounds. The more frequently they attended, particularly with teammates, the less they endorsed the concept that they felt isolated.

We find that caregivers draw a tremendous amount of fulfillment and resilience in hard times from their relationships with colleagues. That is so important. If you have someone you can turn to, someone you can trust, someone who understands, that is huge, no matter how hard things get. I can't say enough about that.

Q - athenahealth's research shows that capable organizations are a powerful protective factor for physicians. Physicians who have the resources to provide optimal care to their patients and the flexibility to provide that care in the way they feel is best show far fewer signs of burnout and feel more connected with patients and colleagues. Does this align with your experience regarding the impact of compassionate care?

Definitely. The more wraparound care and support you can have, the better off patients are going to be, and the happier doctors are going to be. They're happier when they have the time and the flexibility in their schedule to spend however much time they think they should with their patients. And they feel more connected.

The best primary care physicians are those who know what's going on with patients' personal and family lives. You know, their angst, their happiness, their joys, the generations. We're not technicians.

Any organization that facilitates true relationship-based care is a capable organization in my book.