Soul Service: A Hospice Guide to Emotional and Spiritual Care for the Dying - A Deeper Level of Consciousness to Dying

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Is Compassionate Physician Care Obsolete ?

In the past the physician was a medical father figure,accepted into the family and dispensing empathy and compassion. There was an emotional connection with their patients and a bond was formed based on respect and a sincere caring attitude. Today everything has changed. Rarely do physicians spend more than fifteen minutes with a patient in the doctor’soffice. A shift in the concept of service has occurred with doctors attempting to suppress emotional involvement with their patients so that their reasoning ability is not influenced by emotions. Hence, the article in MEDCITY News posted on Feb. 13, 2013 by Deanna Pogorel, where a handwritten condolence note from a doctor was sent to the surviving husband whose wife died in the emergency room of breast cancer. In the note, the female physician explains this was the first such note that she had written in 20 years. The doctor states in the note “Our encounters are typically hurried and do not allow for more personal interaction. However, in your case, I felt a special connection to your wife, who was so engaging and cheerful in spite of her illness and trouble breathing.”
This note struck a chord in over 2.1 million people and1,300 of them left comments, many from those who have also lost parents and many from doctors as well. One physician wrote, “They don’t train us how to deal with the human element of our job very well. Most react by developing a deep callus over their hearts. Some of us are downright evil in how jaded we’ve become…” Another physician writes, “I pray to God when I make it as a trauma surgeon, I do not become desensitized to the sometimes inevitable loss as of life of my fellow man or woman, nor desensitized to the joy of saving or helping to improve the quality of life of my patients.”
How sad that in our world today this simple act of a treating physician writing a handwritten note to a family member following the death of a patient creates such an outcry for more of the same compassionate care. I believe the problem lies within our U.S. system of training of our doctors and nurses. In research for the book Soul Service: A Hospice Guide to the Emotional and Spiritual Care for the Dying (Balboa Press, 2013), it came to light the only 8 U.S.medical schools of the 122 we contacted and none of the 34 top U.S. News and World Reports nursing programs had mandatory training in the areas of emotional, spiritual and palliative care to the dying. Today’s doctors and nurses are not acting out of malice but ignorance of how to connect with their dying patients. If the medical and nursing schools had mandatory required coursework on subjects like the psychology of terminal illness, how to deliver a cancer diagnosis, how to treat cancer pain, when to refer to hospice, how to address a patient’s spiritual needs or how to tell a family that their loved one has died there would be a significant improvement in the quality of terminal care.
From his statements in The Wall Street JournalsTheWeekend Interview, eminent bioethicist Leon Kass comments on the Dangers of a World Increasingly Indifferent to Matters of Human Dignity. He says about real human dignity,"You see it in the way nurses treat people who come in for chemotherapy. You see it in the way a great hostess treats a handicapped guest, helping him without causing him embarrassment. You see it in the way people come close to where there is human suffering and are not put off by the horror but do what is humanly necessary."
His voice lowered almost to a whisper, he adds: "You saw it in Boston. Some people fled to safety—others rushed to the danger."
We all need to consider working at a deeper level of service in our relationships with others to strive not only for dignity but for compassion and not repress that which can be one of the most rewarding of our human experiences.

2 Comments to Is Compassionate Physician Care Obsolete ?:

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Charles Cloninger on Tuesday, May 07, 2013 4:41 PM
One would think that many/some physicians have chosen their path because of the desire to provide loving care to patients. It certainly isn't money as there are easier paths to riches than meeting with a patient in their hospital bed at 6:30 am, rushing off to see a crowded day's worth of patients and coming back at 8:15 pm to check on that patient again. The rigors of med school and following years of training before actually seeing any significant income would, I think, shake out many of the uncaring who are only in it for the money. I feel the villain (or at least a big villain) in all of this is.....the insurance company. Years ago when much of a physician's pay came from the patients own pocket the need to show caring and sympathy loomed large. An uncaring physician had fewer patients. Today insurance drives the train and makes the demands that no physician can ignore. Smaller payments require more patients seen. More patients seen mean less time spent with these same patients. And if you don't know your patients (except for the 45 seconds the physician spends looking at the chart before he enters the room) how in the world can you care about them? There are, of course, exceptions but these are rare as noted above. Sometimes the "country doctor" who lives in a small town and actually meets many of his patients outside of the office may be a special exception. But as long as the payor is not the patient I fear we will never be able to return to the days we older patients remember fondly.
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Christine Cowgill on Friday, May 10, 2013 8:59 AM
Charles: Thank you for your thoughtful comment. The advent of insurance company pressure on doctors to see more patients to make more profit certainly exists. Physicians have their overhead of medical malpractice insurance, office rent, employees, etc. which all continues to go up as well. However, a compassionate medical person will always find the time to smile, shake a hand, give a hug and sincerely communicate with his or her patient.
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