Communication

The Compassionate Practice ®

Part of being an exceptional doctor is being a well-rounded person engaged in the larger fabric of human interest. Developing ideas, connection and interest in humanity as a whole will naturally find its way into a more robust, responsive and meaningful practice of medicine. Not only will it manifest as inroads to connect with colleagues and patients, but it will serve as a natural foundation in resilience that keeps the physician whole. As we become empathetic scholars it is crucial to consider the complement of empathy to scholarship and vice versa. Rather than considering these as two distinct facets of one’s development, we posit the examination and education in how they enhance and elevate one another.

Why does compassion matter in medicine?

In 2018 Drs. Steve Trezciak and Anthony Mazzarelli published Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference, a book based on their two-year journey utilizing biomedical evidence in which they conducted the largest systematic review of the literature related to acts of compassion in healthcare. Their research confirmed what we have observed and heard over the past decade as we trained thousands of healthcare providers and scientists: compassion is important not only in an ethical or emotional sense, but also in a scientific sense. Compassion has a direct, undeniable impact on health outcomes as well as the business of healthcare.

DOES COMPASSION MATTER?

1,300 study subjects – including patients and physicians – were asked if they believed that compassion matters in healthcare:

  • 75% of both patients and physicians said “yes.” They also said it matters so much that it could actually mean the difference between life and death.
  • Most people who attempt suicide have made some type of recent healthcare visit – 38% within the last week and 95% within the last year.
  • 87% said kind treatment is more important than any other key consideration in choosing a healthcare provider, including wait time, travel distance or cost.

THERE IS A DISCONNECT BETWEEN PATIENTS’ AND DOCTORS’ PERCEPTIONS:

  • Nearly half of Americans believe the US healthcare system and health care providers are not compassionate. 64% of patients say they have had a healthcare experience with a meaningful lack of compassion.
  • By contrast, 75% of physicians believe that they are compassionate.

WHY IS THERE A DISCONNECT?

Research shows that physicians routinely miss emotional cues from patients and miss 60 – 90% of opportunities to respond with compassion.

  • Hospitalists miss 68% of opportunities to respond with compassion.
  • Primary care missed 79% of emotional cues and opportunities to respond with compassion.
  • 5 % of statements by surgeons expressed any compassion.

TOP REASONS DOCTORS SAY THEY MISS OPPORTUNITIES TO BE COMPASSIONATE:

  • “I don’t see it.”
  • “I don’t have time.”
  • “I don’t care.”
  • “I don’t know how.”
  • “I don’t believe it really matters”

How do you teach empathy & compassion?

The Compassionate Practice® is an innovative communication curriculum based in the disciplines of theater, Narrative Medicine, journalism, and population health – all connected by the threads of listening, understanding and story. Each of these practices include lessons that directly target the five reasons doctors listed for missing opportunities to be compassionate.  The Compassionate Practice® is above all things a practice. This means it is an ongoing, life-long commitment to self-examination and the exploration of connection with others through curiosity and humility. Here’s how:

THEATER
Actors are trained in an immersive observational process to help them listen to what is spoken, recognize the nuance and importance of what is unspoken, and adapt to changing circumstances. They learn to walk in the shoes of other “characters,” and communicate in ways that impact an audience.  Acting is not about pretending, but about learning to “hold the mirror up to nature” in order to share the story of what it is to be human. At its core, theater training is centered on connecting with others.

 

NARRATIVE MEDICINE
Narrative Medicine is a practical philosophy for patient care that lifts its methods from literary theory.  Strong readers are attentive to the importance of the details in a story; everything from the words the author has chosen, to the representation of the characters.  The arc of the plot collectively flows into our understanding of how another person interprets the world.  This rigorous attention to story, called “close reading,” also applies to how medical care providers may approach observing, listening to and representing patient narratives with dignity and compassion.

 

JOURNALISM
Journalists are driven to understand the big picture through the lens of individuals and the community.  By compiling narratives from different perspectives, they seek to establish an objective portrayal of events.  Journalists are experts in close observation, able to interpret and report back to the world an accurate representation of the story, structuring their message using precise, clear language often under short deadlines.

 

POPULATION HEALTH & SOCIAL JUSTICE
Population Health is about our collective stories – the stories of the rich, the poor, the sick, the healthy, the “them” and the “us”. It explores and negotiates the conditions that impact how we live, survive or thrive. Grappling directly with the most challenging issues of our time in an attempt to understand, challenge and assure conditions in which ALL people can be healthy, population health hinges on a collaborative and adaptable spirit and the necessity of mindful listening to the broad range of lived experiences.

Meet the Faculty

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Chase Crossno, M.P.H.

As the Assistant Artistic Director and Assistant Professor of Medical Education at the TCU UNTHSC SOM Chase leverages theater, art and public health pedagogies to teach the next generation of empathetic scholars. At Boston University she specialized in global health, social justice, and sex, sexuality, gender and health. Chase spent 15 years working in direct patient care with both domestic and international organizations focused on HIV prevention and sexual health education. She is also the proud co-founder of a theatre company in Austin, TX, whose mission is to use curated experiences to raise difficult questions, inspire original thinking and to enrich the cultural landscape.

Chase Crossno, M.P.H.

Assistant Artistic Director & Assistant Professor

EAD, Room 234

817-735-2748

c.crossno@tcu.edu

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Lauren Mitchell, Ph.D.

Lauren Mitchell is an Assistant Professor of Medical Education and Director of Narrative Medicine with the Compassionate Practice program at the TCU and UNTHSC school of medicine and author of The Doulas: Radical Care for Pregnant People.  Prior to coming to academia, she was co-manager of NYC’s Bellevue Hospital’s Reproductive Family Planning program and the Founding Coordinator of The Doula Project, the country’s first organized full-spectrum doula program.  To process the experiences of such intense caregiving, she pursued an obtained a Master’s Degree from Columbia’s Narrative Medicine program, as well as a Ph D in English from Vanderbilt University.  Alienating Aesthetics: Performance Art and the Medical Imagination  is her first academic book project.

Lauren Mitchell, Ph.D.

Director of Narrative Medicine & Assistant Professor

EAD, Room 230

817-735-7766

l.a.mitchell@tcu.edu

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