Empathy

One thing that stayed in my mind from a talk given in 2017 by Professor Ron Paterson was his reference to the “uncanny valley”. There’s something mysterious and catchy about the term. What is this and what does it have to do with the patient experience?

Ron Paterson is a law professor at Auckland University and an international expert on complaints, healthcare quality and the regulation of health professions.

He talked a lot about finding the human connection between patients and health professionals. There is a lot of talk about empathy and compassion in the health field today but Ron insisted that the connection had to be real to be useful to the patient.

The “uncanny valley” is a term borrowed from the science of robotics and art of animation. People connect to a robot that appears human, up to the point where it is so human-like that they have an adverse reaction. There’s something missing, that real humanity. So near, yet so far away. This is the “uncanny valley” on the graph where the connection decreases until it rises again. It can be compared to a doctor going through the motions of appearing sympathetic in a text book, almost robotic way. The patient senses that the empathy and compassion are not genuine and feels more connected to a blunter, plainer spoken professional who is at least “human”. Not that doctors should be rude and abrupt but that they should be genuine.

You will get a clearer understanding of this concept if you read the original Lancet article on this phenomenon. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00161-0/fulltext?rss%3Dyes

Good communication

Ron mentioned the Cartwright Inquiry and the issue of informed consent. This is the heart of the Code of Patients’ Rights.

Trust is vital. The patient trusts the doctor when the doctor shares information with the patient. Listening to the patient is important. They might be “telling you the diagnosis.”

The law says we have a right to effective information and good communication leads to better outcomes.

Maybe it works both ways in that a grumpy patient seems to get worse care. However, it is the patient who isn’t feeling well and the health professional is paid to rise above that.

What patients want

Patients want information and control but they also want guidance. They want a suitable environment. How can there be privacy in a four bedded room when doctors are talking to patients? Nobody expects perfection but we need to aim for the best possible environment.

They want to be listened to or have their family members listened to if they are in pain and the nurse doesn’t believe them.

Ron mentioned a concept called flipping care. Doctors should ask not “What is the matter with you?” but “What matters to you?”. This way they can tailor the information and care to the individual’s unique needs and concerns. For a great video on this see:

http://commonhealth.legacy.wbur.org/2013/12/flipping-health-care-what-matters-to-you

The access to healthcare is important too. Ron’s friend Judi Strid who had a brain cancer had to wait 6 weeks to talk to anyone about her brain tumour.

Patients need access, a person to contact, a business card, a phone number.

The Art of Great Care

This is hard to summarise. It is once more about the human connection. Medicine should be about the relief of suffering.

Here is also advice for patients

  • Take someone with you to appointments
  • Have a list of questions – 2 or 3 of the main things you are worried about
  • Ask how you can contact them after hours
  • Make sure you get copies of your letters or notes.

Finally a quotation from his friend Judi who was a health advocate who had terminal brain cancer and entered the health system as a “secret shopper”.

“If they just treated people nicely and coordinated the care, the system would work much better.”