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Can radical empathy fix our healthcare system?

The history of medicine is a long history of increasingly detailed specializations. When we celebrate momentous breakthroughs in a cure – the authorization of the COVID-19 vaccine or the performance of the first successful heart transplant – what we applaud is the ability of our researchers and doctors to focus on one condition and to provide increasingly effective treatments for even the most dreadful of diseases.

However, we believe that we, the medical professionals and researchers, have gone too far. If we are to fix our ailing healthcare system, our best hope is to reconsider how we treat and cure our patients. We must rekindle the human connection and boldly reimagine the practice of medicine as a community-based and relationship-driven enterprise, expending significant resources to ensure patients see themselves as full partners in healing.

Does this seem too fleeting, too far removed from the harsh prescriptive formula of saving lives?

These instances of one-sided caregiving become much more common when the 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 diseases. This contributed to the massive 46% rise in the gap in life expectancy at birth between the black and white American population between 2019 and the first half of 2020.

We clearly have a systemic problem. Given that 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 – into the conversation. We need to show them that their health is their most precious 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 has stuck with our team for years. In his youth, he had served in Vietnam as an army medic and had traveled to a mountain village where several people desperately needed his services. However, when he attempted to heal these sick villagers, Carmona noticed that they retreated in distrust. For several days he simply lived among the Montagnards, listening to their stories, breaking bread with their leaders and showing them that he wanted to know them and their way of life. Eventually, after earning their trust, Carmona was allowed to ply his trade, and the results were immediate and positive. He prescribed penicillin pills to patients who needed them, then left, vowing 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. The local leaders, beaming, told him that they had placed the necklace on the chests of sick patients, as recommended by their traditional approach to healing.

For a time, Carmona viewed the story as one of failure – after all, he had only limited success in educating mountain villagers about the workings and benefits of Western medicine. But he soon realized that there was a deeper, deeper moral to his story: he was welcomed and trusted by the villagers, he realized, not because he was able to show clear and effective and demonstrable results, but because he had taken the time to show them respect. He was there as a human being, in connection with other human beings, and this basic but too rare approach made the villagers trust him.

How can we apply these lessons in our practice today? A simple solution is to include a more diverse workforce. For example, health systems can provide more appropriate and effective care when health care team members speak the patient’s language and understand their sensitivities. The same goes for community partnerships: with so much of our overall health determined outside of the narrow context of clinical care, redesigning the healthcare delivery model with a more holistic roadmap to include partnerships with non-medical organizations, nationally and locally, 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 our patients’ trust and redesign the way we deliver care goes far beyond radical organizational measures. To reform our healthcare system, the entire medical community will have to rethink the fundamentals of our approach to our work.

Imagine a medical school class that teaches future doctors not only how to have good bedside manners, but also how to share their own stories of hardship and loss, and how to open up about their own failures and successes. Imagine medical education – and practice – focusing on people coming together not as two nodes in a highly impersonal and complex, transactional and monetized process, but rather coming together with empathy, compassion and trust. Such an approach would run counter to hundreds of years of medical history – but we can’t afford not to take this turn.

With more Americans sicker than ever, and with our current mode of healing no longer able to cope with cascading public health crises reducing life expectancy, it’s time to step back and reconsider. . It’s time to reinvigorate the most powerful healing tool in our arsenal: human connection.

Jennifer Mieres, MD, is Northwell Health’s Director of Diversity and Inclusion. Elizabeth McCulloch, PhD, is associate vice president for health equity at Northwell’s Center for Equity of Care. They are co-authors of the book, Reigniting the Human Connection: A Path to Diversity, Equity and Inclusion in Health Care.