A healthy place to work
I blame John Ryan, the CEO of Healthy Place to Work, for all of this. Ever since he mentioned "Dying for a paycheck", I have never been the same. People's health will become the next organizational priority. It is the logical step after digital transformation. Companies will not survive if staff are not fully engaged. Also read "Everyone matters".
Compassionomics take health care as the lens to look at compassion, but the lessons are universal. Compassion is the emotional response to another's pain or suffering, involving an authentic desire to help. It's different from empathy (i.e., detecting and mirroring another's emotions and experiencing their feelings). When a person experiences empathy—the feeling component—the pain centres in the brain light up. When a person is focused on compassion—the distinctly different area of the brain, a "reward" pathway associated with affiliation and positive emotion lights up. Taking action to alleviate another's suffering is a rewarding, positive experience. You can think of it like this: empathy hurts, but compassion heals.
Compassion is good for you
The autonomic nervous system has two components: the sympathetic nervous system and the parasympathetic nervous system. Scientific evidence supports that human connection is a powerful activator of not only positive emotion but also the parasympathetic nervous system. When heart rate variability is high, the body's natural "pacemaker"—the link between the nervous system and the cardiovascular system—is functioning properly. Compassion for others not only improves the receivers' subjective experience (i.e., feeling of warmth), but it can have measurable effects on how the receivers' nervous system and cardiovascular system function.
Compassion is essential
Compassion (or a lack thereof) can have a powerful effect on human beings. It is about the importance of human connection. Darwin has been misread. It is not the fittest that survive. The most compassionate survive. According to Darwin, the communities with the greatest compassion for others would "flourish the best and rear the greatest number of offspring."
The authors curated and synthesized the data from more than 1,000 scientific abstracts and more than 250 original research papers. Here are some of the findings. The book has many more and the case for compassion is compelling:
Epidemiology data indicated that there is currently a compassion crisis in both health care and, more broadly, in the world today.
One-third of all Americans do not even consider compassion for others to be among their core values.
Half of Americans believe our society is not compassionate.
Research supports that compassion is intrinsic to the human condition at a fundamental level.
In the United Kingdom, compassion is considered one of the core values of health care.
Research shows physicians routinely miss emotional clues from patients and miss 60 to 90 per cent of opportunities to respond to patients with compassion.
There is scientific evidence that caring makes a difference.
Compassion facilitates healing.
Compassion can buffer stress-mediated disease.
Compassion can also modulate a patient's perception of pain.
Touch matters. When it was a loved one doing the hand-holding, there was a statistically significant reduction in the rating of pain—by more than 50 per cent. Trust is powerful.
Compassion for patients can also motivate patients to better self-care, i.e., how patients take care of their own health.
Compassion enhances the immune system.
Compassion lowers blood pressure.
Compassion improves functional impairment.
High parental compassion is not only associated with their children having lower emotional distress, but their children also had significantly lower circulating blood markers of systemic inflammation.
Meaningful relationships were associated with 50 per cent higher odds of survival.
Patients randomly assigned to a compassion intervention had 50 per cent lower pain ratings scores than patients randomly assigned to usual care.
In a study of trauma patients, the odds of a patient-reported good outcome were four times higher when the physician was rated as having high compassion.
Patients randomly assigned to receive compassionate palliative care survived, on average, 30 per cent longer.
Multiple studies have shown an association between better patient experience and connecting with or trusting the physician.
Among patients with diabetes, the odds of optimal blood sugar control were 80 per cent higher with high compassion physicians.
Thirty-two per cent of the protective effect of social support against infection was directly attributable to hugs!
There is a statistically significant effect of compassion-based interventions on relief from depression, anxiety, psychological distress, and an increase in well-being. The individual psychiatrist's effects were greater than the drug's effects.
Compassion enhances the placebo effect.
Research shows that compassionate patient care is associated with better patient activation and engagement and, as a result, better patient self-care.
Purpose in life was associated with significantly fewer nights spent as an inpatient in a hospital. People with purpose in life even sleep better at night. If patients do not have a clear sense of purpose in their life, or they have not yet found what it is, this can be a major risk factor for adverse long-term health outcomes.
According to a 2010 study sponsored by the Society for Actuaries, medical errors cost the U.S. $19.5 billion annually, with $17 billion due to avoidable medical costs attributable to the errors, $1.4 billion due to increased mortality rates, and $1.1 billion due to lost productivity from missed work. If compassion moves the needle just a little bit on medical errors, the economic impact could be substantial.
For even the smallest measurable increment of higher compassion (i.e., just one point higher on a 28-point scale), there were 9 per cent lower odds of committing a major medical error in the next three months.
Compassion drives revenue and cuts costs.
Compassion creates "patient-centeredness." Hospitals that recognize the value of this approach are intentional in creating a workplace culture of compassion
Hospitals that are rated highly on their patient experience scores are also higher-performing hospitals financially.
Compassion accounted for 65 per cent of the variation in how patients rated their satisfaction with their health care provider.
The U.S. spent 17.9 per cent of the gross domestic product (GDP) on health care in 2016—that is $3.3 trillion, or $10,348 per person. It is projected to grow to $5.7 trillion by 2026. If the costs of all other goods had grown as quickly as health care costs since 1945, a gallon of milk today would cost $48!
Median charges per patient were 51% lower with patient-centred care.
Primary care patients with unmet expectations for a personal connection with the physician had 41 per cent higher odds of referral to a specialist.
A compassion culture cuts employee absences.
A compassionate workplace culture was associated with lower emotional exhaustion and better psychological vitality among the nurses.
The emotional culture of the health care facility had a strong association with how employees treated their patients, the patients' experience, and even patient outcomes. Doctors who are unable to feel compassion satisfaction due to emotional exhaustion tend to take more sick days and medical leaves of absence.
Fifty-nine per cent of physicians with low compassion satisfaction were contemplating early retirement).
Compassion lowers malpractice costs. The size of the medical liability system, including the cost of defensive medicine, is $56 billion. Several studies have suggested that the doctor-patient relationship—or lack of it—is a major determinant, if not the deciding determinant, of a patient's overall assessment of their treatment and, therefore, a major factor in the decision to pursue a malpractice claim.
Forty seconds of compassion is all you need to make a meaningful difference for a patient.
More compassion did not equate to longer visits.
Compassionate care not only reduced patients' emotional distress, but the effects also persisted up to six months after the clinic visit.
There is efficacy in helping others. That is, the positive emotions associated with making a difference for others change how people feel about their time.
The research is quite clear that giving time actually gives you time.
In 80 per cent of the most scientifically rigorous published studies, compassion training successfully increased physician compassion.
Compassion is not only a powerful therapy for the person receiving compassion, but it is a powerful therapy for the person giving compassion, too.
Burnout isn't just about being overworked; it's also about the absence of meaningful human connection in one's work. The researchers concluded that physician compassion may be protective against burnout.
Nurses with functional MRI evidence of low activity in compassion centres of the brain scored the highest in burnout.
Physicians who had the most dissatisfaction with the quality of their relationships with patients had a 22-fold higher risk of burnout.
For millennia, philosophers and thinkers have intuitively understood that compassion for others could be beneficial for one's own well-being. Seventy per cent of people experience a feel-good sensation when giving meaningful help to others in need.
Compassion for others activates the parasympathetic nervous system by increasing vagus nerve activity. This results in a calming effect that counterbalances the "fight or flight" response of the sympathetic nervous system. Neuroscience research shows that the most potent activator of brain circuits involved in human happiness is compassion.
Science is validating what humans have known throughout the ages: compassion is not a luxury; it is necessary for our well-being, resilience, and survival. Compassion is a (business) no-brainer.