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"Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference" is book about compassion. A book about the business case for compassion. Recommended by Tom Peter in "Excellence Now".
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. Feel good
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.
Only after retirement, I’m understanding the full impact on compassion in health, after serving 40 years in the critical domain of mental and psychiatric health care or even the awareness “I was right when I wanted to see more quality time for nurses to communicate with patients” It also makes so much relevance today, understanding the impact of the lack of compassion during the COVID crisis – also a compassion crisis- and there for essential.
This book came to my awareness through members of my European specialist nurses team on microbial issues and experts in infection control, referring to a podcast of Mitchell and Kiernan with special guest Julie Storr in the open podcast on Compassion and Infection Prevention.
A crucial element is, ‘with compassion to secure sustainability in times of uncertainty’, such as the covid, health economics and the climate of the efficient addiction and a big issue is our health workforce, working conditions, retention. We need to do all in our capacity to see that our contribution to health and its challenges is valued in it’s true proportions and worthwhile to invest in and put compassion on top on all behaviours and health interventions.
There are many examples how low compassion rates impact the health and social wellbeing of patients and let me show care one example, and that are the masks. Many patients are highly depending on facial expressions and just taking time, especially with those with a hearing impairment. Health is complex and getting more complex and the personal contact can not only be replaced with apps. We need to understand the impact wearing masks and therefor lesser communication, and impact for persons in age or those with auditory impairments depending on facial communication. With lower compassionate intervention, it has impact on lesser trust in professionals with too late monitoring and prevention.
After reading this book I truly believe that this is not only for professionals in health but also those in high level administration, policy and regulations responsible for health work force in quantity and quality. This especially to the background that the digitalisation in health what will have a central role with the expectation on lesser personal contact. It will be a challenge to secure compassion in the technical communication domain.
I also find the adherence aspect to compassion of high relevance, what means that one euro invested in communication, information and education is worth a ten folds it’s investment and the ‘40 seconds method’ might be so fundamental. Especially to the background of shortage in nursing and doctors, there is so much prove what is needed and take compassion as a fundamental for all direction, such as instead to saying ‘yes’ to everything with the art for saying ‘no’ becomes very relevant because compassion is making choices and taking matter serious.
I think this book is essential for all decission makers and those in the position and to act accordingly on future restriction policies related in infection prevention and the digitalisation on the health domain and ask the question: "where does the compassion comes in"
The evidence from scholars in many different disciplines is that we humans are born with a capacity for kindness and compassion. Also these valuable attributes and skills can be cultivated. Those of us who are sick and vulnerable silently cry out for gentleness and connection. Over the past thirty years, gains in longevity and quality of life are now at risk due to a new gilded age of unimaginable levels of inequality, a global loss of aboriginal and indigenous languages and cultures , pollution, climate change, loss of living soil and the loss of vast number of life forms. The cultural and intellectual challenge of our times lies in helping as many of us as possible to grapple with the reality that we are living beings not robots . The " Toyota " model and others based on robotic and binary thinking so helpful for some tasks are destroying health-care everywhere we turn. Look at the mission statements and curricula of health-care institutions, licensing bodies , medical schools, schools of nursing, pharmacy, allied health care professionals tragically none mention kindness ,compassion, gentleness and connection. Although inidividuals especially patients, clearly value these vital qualities and skills. Currently their value is neither articulated , nor discussed, nor screened for in applicants. These are not coached, evaluated, mentored nor taught explicitly . All studies show that individually and collectively we fear being perceived as being kind, compassionate, gentle and connecting with patients. These vital qualities are currently misperceived as signs of intellectual weakness and are actively discouraged. As the key differences between compassionate and emotional empathy are neither taught nor understood, there is a terror of connecting with patients. This is felt to impair vital clinical judgement. Clearly toxic altruism and toxic empathy are extremely unhealthy and harmful and to be actively discouraged, whereas warmth and compassionate empathy need to be encouraged .This is why the authors are to be applauded for their courage. As advocating for compassion is viewed as a sure sign of intellectual weakness by many. Disdain for kindness, compassion, gentleness and connection is absolutely characteristic for many high achievers at this time. Sadly it seems that not nearly enough of us imbibed the incredibly nurturing books created by Dr.Seuss. Studying how to help the many Grinches among is to grow their hearts , care and share is not for the faint of heart. Tackling the ubiquitous challenge of the once-lers is also mammoth ie attempting to create emotionally and environmentally safe health-care environments is a huge and much needed task. Collectively we need to collaborate not compete across disciplines to educate our leaders, most of whom pride themselves on cultivating a robotic ability to disconnect and to compartmentalize to change. We need a peaceful cultural and social transformation to encourage each other to cultivate compassionate empathy for ourselves and to all life on our planet. One place to start is by encourage and inspire administrators, learners and educators for all front line professions to this evidence. Data from many different disciplines show that kindness and compassion are not nice, fluffy, shiny "add-ons" or "accessories". Compassionate empathy is what has enabled our ancestors to survive and thrive . Cultivating kindness and compassion for self, for loved ones and especially for all those we s see as " other" has never been more vital. We need to collaborate across all academic, educational and training systems to introduce the latest neuroscience on what it truly means to be a human to everyone. We need to encourage conversations and discussions on these key topics ,everywhere we interact with our fellow human beings. We need to transform ourselves and our systems rapidly. This is why the title of this book by linking the words compassion with the "omics" is truly innovative and wise.
Loved this book and well needed in the nhs. Compassion is essential for patients, relatives and staff. Financially evidence shows it is essential. I read this on kindle and I had to highlight so much of the text as it was so good. Best book I have read so far this year. It does repeat it self but for a good reason, as they highlight the important points. Excellent studies quoted which is perfect.
I will be doing a book review of this for my medical healthcare provider colleagues as a Continuing Medical Education presentation. It can serve as a roadmap on how we can improve the patient experience and quality, and lower cost and burnout, all with the tool of compassion. Very well researched and written.
The authors use evidence-based data to demonstrate how different our world could be if compassion were used in healthcare. They use these demonstrations through the lens of not only the patient but also the care provider. I would recommend this book to anyone in the healthcare industry.
I know we would all like to say we treat each patient with maximum kindness and compassion, but the reality is that we have bad days. We all have those clinics where we are an hour behind or the patients who are frustratingly poor historians or way too chatty than we have time for. The data presented in this book really made me feel convicted. My attitude towards patients may be just as important to improving their health as the prescription I’m about to write for them! That’s insane, if you stop and think about it. Highly recommend this book if you interface with patients in any way.
Compassionate care is more effective, cheaper and more satisfying for patients and carers alike. This book presents the scientific evidence to back up what everyone should have been doing the whole time!
Nobody should be allowed to have a position of authority in any medical system without reading this book first. Full stop, end of story, not open for debate.
A timely book that demonstrates the economic impact compassion has in the health industry. A well-researched book that demonstrates how shifting the focus from treating diseases to caring for people has on stakeholders. Putting compassion at the heart of interactions equalizes the focus on quality and lower costs. The emerging science of compassion is undoubtedly demonstrating its importance in society and the economy. At a time when AI is taking central stage, this timely book presents a compassion-centric paradigm that is called to stay. The book answers the consequences of facing a compassion crisis as well as it demonstrates why compassion matters. If you are interested in awakening compassion at the workplace perhaps you want to explore the work of Dutton and Worline.
A really important book for all people working in health care today. The evidence base behind compassionate care is very strong and the advantages of a compassionate approach for practitioners, patients and the organisation are clearly discussed. The writing is engaging and thought provoking. It is an expensive book as a hard copy but it was important for me to buy this rather than use the electronic version because it is easier to refer to this in my own book writing on this crucial topic. It is such an important text that others may want to buy the hard copy regardless of the expense, but the digital version was easy to read on a tablet.