Volume 6 no 2
Book Review: Compassion-omics: The Revolutionary Scientific Evidence that Caring Makes a Difference
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BOOK REVIEW: Compassion-omics: The Revolutionary Scientific Evidence that Caring Makes a Difference
Stephen Trzeciak and Antony Mazzarelli , Studer Group, 2019
Reviewed by J. Van Aerde, MD, PhD
In Compassionomics — a term reflecting the combination of the art and the science of compassion — Drs. Stephen Trzeciak and Antony Mazzarelli ask whether compassionate care in medicine has made a reasonable difference in the well-being of patients and doctors. Trzeciak is an intensivist and clinical scientist with extensive experience in biomedical systematic reviews, and Mazzarelli is an ER physician, lawyer, and ethicist.
To their surprise, they found decades of evidence with hundreds of studies that had never been synthesized using a vigorous scientific approach. After reviewing more than 1000 abstracts and over 250 peer-reviewed research papers from the biomedical literature, they found that evidence pointed in one direction: compassion in medical and clinical relationships leads to better patient outcomes, lower health care resource use, and reduced medical costs. The authors provide solid evidence that compassion improves many health outcomes, including headache and migraine, back pain, diabetes, HIV, anxiety, depression, and even the common cold.
One explanation might be better patient self-care and improved adherence to prescribed therapy. However, the authors dig deeper for explanations and make connections with physiological and psychological processes. Although compassionate relationships result in better health care quality, the opposite is also true: lack of compassion among health care providers can be a serious patient safety risk.
The book counters five reasons why physicians might miss why compassion is important:
- “I don’t see it; it does not apply to me” — The book provides evidence that many who think they are providing compassionate care actually have a blind spot, a cognitive bias.
- “I don’t have time” — No less than five studies show that it takes, on average, less than 40 seconds to make a meaningful difference to a patient, and such opportunities occur 2.5 times per visit.
- “I don’t care” — Compassion benefits both the receiver and the helper in the caring relationship by reducing the sense of disconnect and burnout. Compassion differs from empathy in that it includes action. That action, to relieve suffering, activates the brain’s “reward” pathways as seen on fMRI. More compassion is associated with less depression, a greater sense of personal accomplishment, and enhanced quality of life. Physicians who are most dissatisfied with the quality of their relationships with patients have a 22-fold higher risk of burnout.
- “I don’t know how” — Like any leadership skill, empathy and compassion can be learned without investment of a lot of personal time or organizational money.
- “I don’t believe it really matters” — That argument will not hold when you have read this book, which offers plenty of evidence that compassion does matter for the receiver, the helper, and organizations in the health care system.
Trzeciak put his findings into practice when, after 20 years in the ICU, he was burned out. He applied the techniques he had been studying, including spending at least 40 seconds during an appointment practising compassion toward patients. Once he connected more, cared more, leaned in rather than withdrawing, the fog of burnout started to lift and changed into what he calls “helper’s high.”
No matter how much technology tries to take away from our humanity, this book proves the importance of compassion and brings us back to what has been the essence of medicine since the days of Hippocrates: relationship-centred care.
Author
Johny Van Aerde, MD, PhD, FRCPC
Correspondence to:
This article has been peer reviewed.