The history of medicine has been a long history of increasingly fine-grained specialization. When we celebrate momentous breakthroughs in healing, authorizing the vaccine against COVID-19 or performing the first successful heart transplant, what we applaud is the ability of our researchers and doctors to focus on one condition and deliver treatments every time more efficient even for the most. disease deterrent.
However, we believe that we, health professionals and researchers, have gone too far. If we want to fix our ailing healthcare system, our best hope is to reconsider how we treat and heal our patients. We must rekindle human connection and boldly reimagine the practice of medicine as a community-minded, relational enterprise, expending considerable resources to ensure that patients see themselves as full partners in healing.
Does it seem too ephemeral, too far removed from the hard prescriptive formula of saving lives?
Such cases of one-sided care delivery are much more common when patients are not privileged individuals with access to resources, education, and excellent care. Women, people of color, and immigrants with limited English proficiency are at greater risk of misdiagnosis, underrecognition, and undertreatment for many illnesses. This contributed to the massive 46% increase in the gap in life expectancy at birth between the US black and white population between 2019 and the first half of 2020.
Clearly, we have a systemic problem. Since 80% of our well-being is determined by factors such as access to health care, physical environment and lifestyle choices, we need to close this gap by rethinking how we invite patients, especially those who feel most disenfranchised , in the conversation. We must show them that their health is their most valuable asset and encourage their partnership as active participants in their health.
Richard Carmona, MD, MPH, the former US Surgeon General, once told us a story that stuck with our team for years. As a young man, he had served in Vietnam as an army medic and visited a Montagnard village where several people were in dire need of his services. However, when he tried to treat these sick villagers, Carmona noticed that they withdrew suspiciously. For several days he did nothing but live among the Montagnard people, listening to their stories, breaking bread with their leaders and showing them that he wanted to know them and their way of life. Finally, after gaining their trust, Carmona was able to practice his craft, and the results were immediate and positive. He prescribed penicillin pills to patients who needed them and then left, promising to return a few weeks later. When he did, he was greeted with fanfare and given a precious gift: a necklace with the 40 penicillin pills he had left behind. Local leaders, beaming, told him that they had placed the necklace on the chest of sick patients, as recommended by their traditional approach to healing.
For a time, Carmona considered the story as one of failure; after all, he had limited success in educating the Montagnard villagers about the workings and benefits of Western medicine. But he soon realized that his story had a deeper and deeper moral: the villagers welcomed and trusted him, not because he was able to show clear, efficient and demonstrable results, but because he had taken the time to do it show them respect He was there as a human being, connecting with other human beings, and this basic but all-too-rare approach made the villagers trust him.
How can we apply these lessons to our practice today? A simple solution is the inclusion of a more diverse workforce. For example, health systems can provide more appropriate and effective care when members of the care team speak the patient’s language and understand their sensitivities. The same is true of community partnerships: with much of our global health determined outside the narrow context of clinical care, redesigning the healthcare delivery model with a more holistic roadmap to include partnerships with non- healthcare, at national and local level, can make a big difference in optimizing healthy behaviors and encouraging healthier lifestyle choices.
But the kind of radical empathy we need if we are to earn the trust of our patients and overhaul the way we deliver care goes far beyond radical organizational measures. To reform our health care system, the entire medical community will need to rethink the fundamentals of how we approach our work.
Imagine a medical school class that teaches future doctors not only how to sleep well, but also how to share their own stories of hardship and loss, and how to open up about their own failures and successes. Imagine if medical education (and practice) focused on bringing people together not as two nodes in a highly impersonal and complex, transactional, monetized process, but joined together with empathy, compassion, and trust . Such an approach would fly in the face of hundreds of years of medical history, but we cannot afford not to take this turn.
With more Americans sicker than ever before and with our current way of healing no longer able to cope with cascading public health crises that reduce life expectancy, it’s time to rewind and reconsider it It’s time to reactivate the most powerful healing tool in our arsenal: human connection.
Jennifer Mieres, MD, is the chief diversity and inclusion officer at Northwell Health. Elizabeth McCulloch, PhD, is Assistant Vice President for Health Equity at the Northwell Center for Equity in Care. They are co-authors of the book, Rekindling the Human Connection: A Path to Diversity, Equity, and Inclusion in Health Care.