Restoring Clinicians’ True Purpose: Healing

Steve Prokesch, Senior Editor, HBR     

Gardiner Morse, Senior Editor, HBR 

Health systems that pressure doctors to see more patients. Mountains of work created by electronic medical record systems. A relentless push to cut costs. These burdens mean that providers have less time to spend with patients — connecting with them on a personal level, addressing their emotional needs, and understanding their care preferences. But there’s a bright side: Doctors and nurses are pushing back, and some provider organizations are listening. 

In a moving essay, Rana L.A. Awdish of the Henry Ford Health System and Leonard L. Berry of Texas A&M University call for clinicians and their institutions to return to their true purpose: healing. They make the case for sharing power with patients, giving them emotional and spiritual space, and treating them with kindness — and they emphasize that these things can’t happen without the right culture and leadership. People must take precedence over spreadsheets, they say. 

Brad Stuart, an expert in managing patients with advanced illnesses, couldn’t agree more. He finds a hopeful sign in the soon-to-launch Primary Care First initiative of the Centers for Medicare and Medicaid Services (CMS), which will pay primary care physicians to help seriously ill patients transition from curative treatment to excellent end-of-life care. That will mean managing patients’ hopes, a task requiring deep empathy, compassion, and patience — qualities not typically emphasized in medical training. 

Yet another heartening indication is a primary care model recently introduced in Connecticut by CareMore Health, a provider serving Medicare and Medicaid patients. It’s aimed at improving the physical and mental health care of high-cost, high-needs patients, and its central pillar is a practice largely abandoned long ago: making house calls. Paul Di Capua and colleagues at CareMore relate how one “home team” talked not only with the patient (a man suffering from advanced kidney disease and other chronic conditions that landed him in the ER almost weekly) but also with his brother, a close friend, and his personal care assistant to devise a treatment regimen. The result: The patient’s kidney function stabilized. Initial data on the model indicates that it has so far reduced hospital admissions and ER visits by 13% and 27%, respectively. 

As that program demonstrates, prioritizing the patient can be a win-win-win: Patients get better care, clinicians become more engaged, and provider institutions see their profits grow. Press Ganey’s Nell W. Buhlman and Thomas H. Lee share data from 3,411 U.S. hospitals that proves the point. They found that improving both the patient experience and employee engagement scores leads to higher ratings in the CMS HCAHPS survey — and every one-point rating increase is associated with a 0.2% rise in a hospital’s net operating profit margin. What steps is your institution taking to improve the patient experience — to empower caregivers to put patients first? Are you finding that such initiatives don’t have to compromise financial performance? Please share your stories; email us at newsletterteam@hbr.org. Until next time, 

Steve Prokesch 

Gardiner Morse