An interesting article in the Cleveland Clinic News Wire highlights an issue that is becoming more prevalent after the passing of the Affordable Care Act which is the idea of patient quality care over quantity. The article talks about empathy and its place in health care. Now that healthcare exchanges are being incentivized for quality over quantity and less patient returns, it seemed very fitting as we approach 2013 and the soon to be enactment of the ACA.
Dr. Delos “Toby” Cosgrove, CEO & President of Cleveland Clinic, writes poignantly about an epiphany that affected the way he practiced medicine. He recalls that although it happened eight years ago, he remembers it like it was yesterday. He had been invited to Harvard Business School to discuss a case study on Cleveland Clinic. After a very positive first session, a student at the second session raised her hand and said, “Dr. Cosgrove, my father needed mitral valve surgery. We knew about Cleveland Clinic and the excellent results you had. But we decided not to go because we heard you had no empathy there. We went to another hospital instead.”
The student then asked him, “Dr. Cosgrove, do you teach empathy at Cleveland Clinic?”
He then recalls ten days later, he was visiting Saudi Arabia for the opening of a hospital. And it couldn’t have been written more perfectly but the president of the hospital stood up and said, “This hospital is dedicated to the body, the spirit and the soul of the patient.”
He said at that moment he had to take personal inventory.
Dr. Cosgrove realized that he had spent his life in the pursuit of technical excellence so people wouldn’t die on the operating table. But he spent very little time looking after patients as whole individuals. So he said, “I’m going to do something about this.”
He established the Cleveland Clinic Office of Patient Experience. And as he writes it, “we went from a doctor-centered organization to a patient-centered structure with 26 institutes and support centers.”
Today the good doctor says what is most important, “I can look our patients and their families in the eye and say, ‘Yes we do teach empathy. We’ve made it part of our culture.’ There’s still a long way to go. But we’re on our way.”
While Dr. Cosgrove may have been a bit ahead of his time, health care reform is demanding this change not only in the incentive programs offered by the ACA but also by patients who are living longer and getting smarter. And it not only stems from a negative distrust of the system—which in some cases is true—but it also comes from the fact that because Americans have such wide choices when it comes to a total healthcare package, many no longer stand for technical brilliance without empathy and quality. There has also been a move toward combining Eastern philosophies of total wellness with medical science which was actually frowned on many years ago. Wellness doctors like Dr. Andrew Weil who not only emphasized the body but the mind and total well being were considered quacks. It will be interesting to see if health care reform and the ACA, even with quality incentive programs, will encourage or diminish the need for empathy as a vital part of our medical system. Will we be able to sustain quality care as opposed to mass care over the course of this massive and expensive overhaul?