Provider feedback reinforces relationship-centered care

by Thomas Dahlborg

In my December blog post I wrote that I needed to find a different path to convince healthcare leaders how truly important relationship is to healing.

Since that time the feedback shared relative to the importance of relationship in healing has been a blessing.

Some responses from readers ...

• "Knowing a patient is not compliant and also knowing why a patient is not compliant is the only way forward to bridging the gap between treatment plan and reality and ultimately better patient outcomes. It can be as simple as that. One will not discover any of the above without a relationship with the patient." - Hilda Kidder

• "It is the relationship that makes the impact on the patient and it can have a negative or positive impact depending on how we speak and listen to, understand and view the patient." - Joyce Hyam
• "Not being able to connect at a human level is, sadly, the reason why we have to highlight and define "patient centered care." - Dianne

The feedback also enlightened me about amazing organizations like Children's Hospital of Wisconsin's Gastroenterology, Hepatology and Nutrition Center ...

• Not only does this organization provide patient-centered care by developing relationship with the individual patient (the child), this organization provides family-centered care. They hold the whole family, developing authentic relationships, creating partnerships and engaging the family around their beliefs and building on the family’s strengths.
• And by having an authentic relationship with the family this amazing organization is also well-positioned to fully leverage an interdisciplinary approach to care for the child (which consists of engaging doctors, mental health practitioners, social workers, therapists, dieticians and other practitioners) working as a team to meet the specific needs of the child and family.

It directed me to the article " Healing relationships and the existential philosophy of Martin Buber " published in the Philosophy, Ethics, and Humanities in Medicine journal ...

• "Our study used exemplar clinicians who had special interest and expertise in developing healing relationships with patients. We found that these clinicians, in contrast to literature describing the pervasive atmosphere of physician burnout and demoralization in primary care, enjoyed their work and derived positive energy from their relationships with patients, even though they had been in practice for many years, some in very challenging practice environments."

Readers also shared the TED Talk by Abraham Verghese, " A doctor's touch " with me ...

• The focus on data is overruling the focus on the patient. "The patient in the bed has almost become an icon for the 'real' patient (the I-patient) in the computer."
• Data analysis and review is becoming more important than the relationship between the clinician and the patient. The loss of attentiveness (and truly being present) to the patient (the average American physician interrupts their patient within 14 seconds and thus never hears the patient's whole story) is not only the loss of relationship between the physician and patient but also is the loss of a classic healing ritual between the physician and patient. And without this ritual (without this connection) the "critically important message the physician needs to communicate with their patient (that is cathartic to the clinician, necessary for the patient and has meaning and a singular message to be conveyed to the patient)" is never fully shared.

All truly a blessing. But what does it mean?

This means there are healthcare practitioners currently working within the broken healthcare system, who against major obstacles are bringing relationship between a clinician and patient back into the healing encounter, and in so doing, having a positive impact on their patients.

It means an organization that currently exists within the broken healthcare system has found a way to not only bring relationship and patient-centered care back into healing, but also family-centered care--making a difference for both patient and family.

This means a focus on relationship in healing is not only shown to be possible, but it also is shown to improve patient outcomes while improving physician satisfaction, retention and health.

This also means courageous healthcare leaders are finding more and more forums to share the importance of relationship, empathy, connection, and trust in healing. More and more healthcare leaders will be hearing the message, and more and more patients will know the following to be true:

I (your clinician) care ... "I will always always always be there; I will see you through this, I will never abandon you, I will be with you 'til the end."¹

^{1. Abraham Verghese: A doctor's touch, TEDGlobal 2011, Filmed July 2011}

Thomas H. Dahlborg, M.S.M., is Vice President for Strategy and Project Director for the National Initiative for Children's Healthcare Quality ( NICHQ ), where he focuses on improving child health and well-being. He has 23 years of experience leading collaboratively, creating optimal healing environments, analyzing and addressing practitioner and patient needs, and developing and implementing aligned strategic plans.