Compassionate Care: The Difference Between Life and Death

Facing near-certain death, Schwartz wrote that his "ordeal has been punctuated by moments of exquisite compassion. I have been the recipient of an extraordinary array of human and humane responses to my plight. These acts of kindness — the simple touch from my caregivers — have made the unbearable bearable." He died in September 1995, about 10 months after his diagnosis.

These days, The Schwartz Center sponsors projects ranging from medical education and scientific research to dispersing grants, all to promote the practice of compassionate care in medicine. This week, they released a new national survey of doctors and patients. The most surprising finding is this:

When asked whether "good communication" and "emotional support" can make a difference in whether a patient lives or dies, 81 percent of patients said: Yes. But what's really shocking, is that 71 percent of doctors also agreed. That means that the vast majority of patients and doctors believe that compassionate care, defined as an emotionally supportive provider who actually talks and listens to his or her patients, can mean the difference between life and death.

Beth Lown, medical director for The Schwartz Center, and an internist at Mt. Auburn Hospital in Cambridge, helped devise the latest survey, which includes 800 patients and 500 doctors. She said she believes scientific advances in medicine, and cutting-edge technologies and treatments have largely "superceded" low-tech care that includes dialogue, communication and trust. "There's such a high priority put on medical intervention — and to a large extent technical skill is valued above interpersonal, relational skill — that I was surprised to see the extent to which everyone agrees that communication and emotional support makes this kind of difference," she said.

"I think it represents a yearning for these kinds of relationships."

The study wasn't broken down by subspecialty, and I imagine if you asked patients facing brain surgery whether they preferred a compassionate guy or an expert technician as their surgeon, compassion might slip down the priority ladder. Or maybe not.

Numerous studies have shown that good communication and strong bonds between doctors and patients lead to better health outcomes and far fewer medical errors, Dr. Lown said. Still other studies found that people's immune systems are better able to fend off insults if they, as patients, have a sense of well-being and optimism, she said, though the mechanisms behind this phenomenon remain murky.

So maybe it's time to demand a brain surgeon who is at once communicative and nurturing, and at the same time a ruthless technician.

Readers, let us know whether the compassion of a medical provider has actually helped you feel better? Or do you think that top-knotch medical skills and up-to-the-minute knowledge of the latest scientific research is the most important part of quality care?