I distinctly recall the moment I decided to become a physician. I was sitting on a bench in the hallway of Coney Island Hospital in Brooklyn, beside my aunt and older cousin, as we waited for the physicians to complete their examination of my beloved grandmother, in her early 90s, who was seriously ill. She doted on all of her grandchildren, particularly me, as I was the youngest. I loved my grandmother dearly. I recall seeing the doctors, dressed in their white uniforms, emerge from her room, holding her life in their hands. They eagerly reported what turned out to be good news, and thankfully, she lived over a year, and I entered the path to spend my life as a physician. Clearly, what drove me into the field of medicine was the compassion these doctors exhibited—their sincere desire to care for and improve the lives of others.
Amazingly, thirty-seven years later, I found myself as chancellor for health affairs at Duke University and dean of the Duke University School of Medicine where I oversaw the selection of our medical students. The school was in an enviable position of having thousands of applicants with the highest academic standards for a class of 100 students. While maintaining the most rigorous standards for scholastic achievement, we selected only those who convincingly demonstrated their compassion to serve the needs of others. But, what has become apparent to me is that the sincere desire to deliver compassionate care—what drives most individuals to become physicians—is greatly challenged by the rigor and difficulties of medical education and even more so by the current practice of medicine. Many factors are responsible for this, including the increasingly technical nature of medicine, the shortage of time available to engage with patients, and the ongoing bureaucratic issues needed for compliance. However, the lack of focus on compassion, the basic emotion bringing physicians to medicine, has, in my view, greatly reduced the joy of practicing medicine and the benefits that physicians can bring to their patients. Importantly, the lack of deep meaningful engagement between physicians and patients also greatly diminishes the value of care as patient behavior changes to achieve the best outcome is greatly dependent on the physician-patient relationship.
Being committed to develop more effective, proactive, personalized models of care delivery, I have become increasingly interested in developing approaches to care that maximize compassionate interaction between the patient and their physician, while increasing the effectiveness and enjoyment of this engagement. This being the case, I sought the opportunity to discuss compassion with the most recognized expert in compassion in the world, His Holiness the 14th Dalai Lama. Join me in learning what resulted from this meeting and how compassion can be brought back to the practice of medicine in my recent Academic Medicine Invited Commentary.
By Ralph Snyderman, MD – featured on the Academic Medicine Blog
R.S. is James B. Duke Professor of Medicine and director, Center for Personalized Health Care, Duke University School of Medicine, and chancellor emeritus, Duke University, Durham, North Carolina.
Snyderman, R. Compassion and health care: A discussion with the Dalai Lama [published online ahead of print March 12, 2019]. Acad Med. doi: 10.1097/ACM.0000000000002709.