By L. Carol Ritchie for NPR
For most of his career, Dr. Stephen Trzeciak was not a big believer in the “touchy-feely” side of medicine. As a specialist in intensive care and chief of medicine at Cooper University Health Care in Camden, N.J., Trzeciak felt most at home in the hard sciences.
Then his new boss, Dr. Anthony Mazzarelli, came to him with a problem: Recent studies had shown an epidemic of burnout among health care providers. As co-president of Cooper, Mazzarelli was in charge of a major medical system and needed to find ways to improve patient care.
He had a mission for Trzeciak — he wanted him to find answers to this question: Can treating patients with medicine and compassion make a measurable difference on the wellbeing of both patients and doctors?
Trzeciak wasn’t convinced. Sure, compassion is good, Trzeciak thought, but he expected to review the existing science and report back the bad news that caring has no quantitative rationale. But Mazzarelli was his colleague and chief, so he dove in.
After considering more than 1,000 scientific abstracts and 250 research papers, Trzeciak and Mazzarelli were surprised to find that the answer was, resoundingly, yes. When health care providers take the time to make human connections that help end suffering, patient outcomes improve and medical costs decrease. Among other benefits, compassion reduces pain, improves healing, lowers blood pressure and helps alleviate depression and anxiety.
In their new book, Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference, Trzeciak and Mazzarelli lay out research showing the benefits of compassion, and how it can be learned. One study they cite shows that when patients received a message of empathy, kindness and support that lasted just 40 seconds their anxiety was measurably reduced.
But compassion doesn’t just benefit its recipients, Trzeciak and Mazzarelli learned. Researchers at the Wharton School of the University of Pennsylvania found that when people spent time doing good for others (by writing an encouraging note to a gravely ill child), it actually changed their perception of time to make them feel they had more of it.
For doctors, this point is crucial. Fifty-six percent say they don’t have time to be empathetic.
“The evidence shows that when you invest time in other people, you actually feel that you have more time, or that you’re not so much in a hurry,” Trzeciak says. “So when 56 percent say they don’t have time in that survey, it’s probably all in their heads.”
The good news is, the same study that found doctors didn’t have time for empathy, also showed that a short training in the neuroscience of empathy made doctors interact with patients in ways patients rated as more empathetic.
Compassion also seems to prevent doctor burnout — a condition that affects almost half of U.S. physicians. Medical schools often warn students not to get too close to patients, because too much exposure to human suffering is likely to lead to exhaustion, Trzeciak says. But the opposite appears to be true: Evidence shows that connecting with patients makes physicians happier and more fulfilled.
“We’ve always heard that burnout crushes compassion. It’s probably more likely that those people with low compassion, those are the ones that are predisposed to burnout,” Trzeciak said. “That human connection — and specifically a compassionate connection — can actually build resilience and resistance to burnout.”
Trzeciak and Mazzarelli hope their evidenced-based arguments will spur medical schools to make compassion part of the curriculum.
For those outside the health care system, acting with compassion can be a kind of therapy as well, the authors say. They cite the phenomenon of the “helper’s high,” the good feeling that comes from helping others, and explain how giving to others benefits the givers’ brains and nervous systems.
“I can say this with confidence,” Trzeciak says. “Other-focused behavior is beneficial to your own mental health.”
For Trzeciak, the research had a personal effect. When he started into the project, he’d been going through his own existential crisis, triggered by his son’s middle school homework assignment that asked, “What is the most pressing problem of our time?” While he believed his work to that point was meaningful, it was definitely not the most pressing problem of our time.
Along the way, he says, he realized he was feeling burned out after 20 years of practicing medicine. So, armed with data from his book research, he decided to test his own hypothesis.
“The recommended prescription is what I call ‘escapism’ — get away, detach, pull back, go on some nature hikes or whatever but I was not believing it,” Trzeciak explains in a TEDxPenn talk.
Instead, he says, he applied the techniques he’d been studying, including spending at least 40 seconds expressing compassion to patients. “I connected more, not less; cared more, not less; leaned in rather than pulled back. And that was when the fog of burnout began to lift.”
He prescribes the same for anyone, not just health care providers, suffering from mental or emotional exhaustion.
“Look around you and see those in need of compassion and give your 40 seconds of compassion,” he says. “See how it transforms your experience.”