Nursing America’s Medical System Back to Health
The health care field is constantly optimizing to keep up with an ever-changing world. However, in recent years many Americans have expressed complete dissatisfaction with the current health care system. This is surprising considering that the U.S. is considered economically superior to most other countries in the world. To put this into perspective, “The U.S. spends more on health care as a share of the economy — nearly twice as much as the average OECD [Organization for Economic Co-operation and Development] country — yet has the lowest life expectancy and highest suicide rates among the 11 nations” (Tikkanen and Abrams 2020). While there are many suggestions as to how to save American health care, currently one of the most prominent is through the use of Compassionomics, a term coined by Drs. Stephen Trzeciak and Anthony Mazzarelli in their book Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference. Incorporating compassion into the hospital setting is their key to a reformed medical system. Despite what Drs. Trzeciak and Mazzarelli conclude in their book, the answer to better health care is not that simple and is in fact multifaceted. While compassion in the health care industry is a necessary factor for patients to receive a high level of care, in order to truly revolutionize the health care industry, socioeconomic issues, mental health amongst hospital staff, and lack of resources must be addressed as well.
Written by qualified physician scientists, the book Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference contributes an interesting perspective into the shortcomings of the American health care system. Based on firsthand accounts that the authors Drs. Trzeciak and Mazzarelli witnessed while treating patients, the book retells the anecdotes that led them to conclude that a compassionate staff can drastically change the outcome of a patient’s healing. One of the driving forces behind the investigation of compassion’s effect on healing is the story of Dr. Edward Viner, a colleague of Drs. Trzeciak and Mazzarelli. Dr. Viner noticed that during his time as a patient in the Intensive Care Unit, his care team was very compassionate to him. He credits this compassion for his quick recovery and his pleasant hospital experience. Wanting to further research his theory, Drs. Trzeciak and Mazzarelli set out to test this hypothesis using scientific methods. The supporting evidence that the authors provided to prove their theory came in the form of anecdotes and controlled experiments. These controlled experiments consisted of an inflicted wound identical for all test subjects. Then, some subjects were given supportive interactions while others were given discouraging or rude interactions. The rate of wound healing was measured. The results from this test showed that those who were given supportive interactions showed a faster rate of wound healing. From this, Drs. Trzeciak and Mazzarelli concluded that emotional sympathy had a noticeable effect on patient health. Through anecdotal evidence, the authors deduced that in cases where patients were able to spend less time in the hospital, reach a diagnosis quickly, or require less testing, the team in charge of that patient showed a significant amount of compassion when handling their care. Thinking from a business perspective, Drs. Trzeciak and Mazzarelli realized that the benefits of compassion translated to economic gain. Hospitals that had a more compassionate care team could, in theory, spend less money per patient as less resources are being used by the patient. Thus, the term Compassionomics was born.
While Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference is an enjoyable book to read, the evidence used to support the authors’ claims about the importance of compassion is not convincing. The anecdotes included in the book show amazing examples of the strength of humans and can be seen as an uplifting lesson on how treating others with respect and sympathy can make all the difference. Dr. Esther Strahan writes in a book review, “The style is engaging and conversational, and the patient stories are compelling” (2020). In this sense, the book can appeal to those that are not knowledgeable on the medical field. However, those familiar with these topics can see that the support used as “scientific evidence” falls short of being classified as such. To start, the studies referenced in Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference used methods that would not yield the most accurate results. As the emotional response given to each patient was occurring live, there was no way to deliver an identical response in order to test the theory for each patient. The guidelines for this response was not outlined in the book nor was the system to determine what constituted a severe or mild response. Because there was no way to measure the severity of the response given to each patient in the study, it could have easily been manipulated to agree with the authors’ hypothesis and it would be hard to reproduce this experiment for further testing on the matter. Should another researcher want to test this experiment to corroborate the findings of Drs. Trzeciak and Mazzarelli, it would be nearly impossible to ensure that the conditions are the same. This is further in conflict with good lab practices, as many researchers are in agreeance with the representation of their findings in a way such that others may follow their methods and observe the same outcome. Fiona Johnstone uses her book review to voice her critiques that, “…details of the experimental interventions are often vague, making it difficult to parse what exactly is being tested under the guise of ‘compassion’” (2020). This contributes to the lack of conviction for the claims that Drs. Trzeciak and Mazzarelli make on the basis of this scientific evidence. Another issue with the experimentation was the lack of data from the studies. This lines up with the opinions of other reviews of the book, citing, “…the need for an index” (Strahan 2020). Including an index of data would strengthen their argument as the reader would be able to corroborate the findings of Drs. Trzeciak and Mazzarelli with concrete numbers. These are important criticisms considering the book heavily relies on its use of scientific evidence to persuade the audience, going so far as advertising it in the title itself.
From the inclusion of anecdotal evidence as means of supporting their hypothesis comes the introduction of inadvertent confirmation bias into this book. This is concerning considering respectable science strives to be free from bias or hidden agenda. By connecting the study to a way of profiting off of compassion, two questions come to mind: If it is in the name of economic profit, is it genuinely compassion? Also, is a hospital a business or a safe place for patients to heal? In this way, it seems that the term Compassionomics is self-contradictory and could be fueled by personal interests of those wanting to economically exploit patients rather than serving the public good. The anecdotal evidence itself can be considered biased when analyzing the portrayal of the benefits of compassion it accomplishes. Incorporating stories that the authors or their colleagues personally witnessed paints a very one-sided picture that fails to consider factors that could be barriers in health care relevant to hospitals other than their own. While compassion may save the hospitals of Drs. Trzeciak and Mazzarelli, compassion alone will not save American health care.
In order to address issues within the medical field in the United States, the needs of the community must be prioritized. Many of the times, low-income areas disproportionately face barriers to health care compared to high income areas. Because of this, the needs of impoverished communities are typically more abundant than that of affluent communities. The most prominent barrier that low-income patients must climb is their inaccessibility to health care. This encompasses a multitude of reasons why these disadvantaged patients cannot receive proper medical attention. For these reasons, it has been shown,” … that greater affordability, availability of after-hours appointments, telehealth, and enhanced patient trust can significantly improve access to needed care,” and thus improve health care in these underprivileged areas (Lewis et al. 2017). Another contributing factor to a patient’s level of care that is affected by socioeconomics is the resources of a hospital, or lack thereof. While some hospitals that cater to wealthy patients have a high doctor to patient ratio, the most up to date medical technology available, and strawberry infused water available, other clinics that are in the price range of working-class Americans may only have one doctor, old and inaccurate equipment, or lack the proper equipment to diagnosis or treat certain conditions. While both facilities could benefit from compassionate staff, it is clear which of the two needs much more than just that. To this extent, Drs. Trzeciak and Mazzarelli’s claim that compassion is what is needed to revolutionize the health care industry is much too simple and leaves out the many other fundamentals of proper medicine.
While showing compassion to patients is important, extending this same compassion to health care workers is arguably more paramount than ever in the interest of cultivating a higher standard of care in hospitals. Health care workers have a unique profession where they are put in a position of seeing others in pain and suffering nearly every day. This takes a large emotional toll on them and can lead to something referred to as compassion fatigue. Detailed by Megan Schumann, “Compassion fatigue is the natural, negative consequence of direct involvement of helping a traumatized or suffering person” (2021). This can lead to mental health issues as health care workers are expected to deal with this on their own for the most part. As the coronavirus pandemic thrives, hospital staff have seen a drastic increase in the number of patients they treat compared to the number pre-pandemic. Because of this, health care workers across the country have felt overworked and drained from their jobs. Coupling the spike in patients and the already present compassion fatigue, many hospital workers feel plagued by big expectations. During the pandemic, “Health care professionals have served as surrogate family members for sick and dying patients… some workers have felt heightened fatigue, depression, insomnia and experienced “feeling the pain” of others, excessive thoughts about their patients, chronic negativity, low morale, diminished empathy, feelings of helplessness, poor concentration and vulnerability to substance abuse (Schumann 2021). This far extends beyond the expectations any other profession has for their employees. However, studies have shown that providing mental health support in the form of therapy or lessons on self-care can counteract the negative effects of compassion fatigue. Lily Jackson, a practicing therapist, counsels that, “Compassion fatigue is reversible but working through those feelings takes time, therapy and self-awareness. That involves taking a much-needed break and walking away from situations until your mind and body are ready to go back to those challenging situations” (2021). This is an important aspect of health care that many overlook, instead turning their attention to the patients. In order to show compassion to patients, hospital staff must be able to mentally handle what the day brings them.
Albeit a valuable characteristic when treating patients, compassion alone is not the key to revolutionizing American health care. Drs. Trzeciak and Mazzarelli’s take on this in Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference contributes an interesting but narrow view on the importance of compassion in accelerating wound healing and lowering health care related costs for hospitals. While compassion does have a place in the hospital, it must be for everyone, not just the patients. The topic of health care in America has many moving pieces, and in order to fully address it a simple answer must be left behind in favor of a holistic approach. Tackling this from all facets means providing targeted care for disadvantaged communities and the health care professionals that are serving the ill. There is no debate that America’s health care system is sick and in need of a change. Just as a doctor would make a diagnosis before prescribing treatment, the underlying issues must be addressed if a lasting change is to be made.
References
Jackson, Lily. “Pandemic Got You Numb? Therapists Have a Word for It: Compassion Fatigue.” Reckon South, 25 Feb. 2021, https://www.reckonsouth.com/compassion-fatigue/#:~:text=Compassion%20fatigue%20is%20reversible%2C%20Figley,back%20to%20those%20challenging%20situations.
Johnstone, Fiona. “Compassionomics.” The Polyphony, 2020, https://thepolyphony.org/2020/03/30/compassionomics/.
Lewis, Corinne, et al. “Listening to Low-Income Patients: Obstacles to the Care We Need, When We Need It.”
Obstacles for Low-Income Patients, The Commonwealth Fund, 2017, https://www.commonwealthfund.org/blog/2017/listening-low-income-patients-obstaclescare-we-need-when-we-need-it.
Schumann, Megan. “The Cost of Caring.” Rutgers University, 2021, https://www.rutgers.edu/news/cost-caring.
Strahan, Esther. “Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference.”
Family Medicine, STFM, 2020, https://journals.stfm.org/familymedicine/2020/june/br-jun20-strahan/.
Tikkanen, Roosa, and Melinda Abrams. “U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes?” U.S. Health Care from a Global Perspective, 2019 | Commonwealth Fund, 2020, https://www.commonwealthfund.org/publications/issuebriefs/2020/jan/us-health-care-global-perspective-2019.
Trzeciak, Stephen, and Anthony Mazzarelli. Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference. Studer Group, 2019.
