Can Radical Empathy Fix Our Health Care System?

The history of medicine has been a long story of increasingly minute specialization. When we celebrate critical breakthroughs in healing — authorizing a COVID-19 vaccine or performing the first successful heart transplant — what we admire is the ability of our researchers and clinicians to zero in on a condition and deliver the most effective treatments. Fear of diseases.

However, we believe that we – healthcare professionals and researchers – have gone too far. If we want to fix our sick healthcare system, our best hope is to rethink how we treat and heal our patients. We need to rekindle the human connection and boldly reimagine the practice of medicine as a communal and relationship-minded undertaking, devoting sufficient resources to patients seeing themselves as full partners in treatment.

Does this strike you as a momentary departure from the hard-edged prescriptive formula of life-saving?

These instances of one-sided provision of care are often exacerbated when patients are not privileged individuals with access to resources, education, and excellent care. Women, people of color, and immigrants with limited English proficiency are at greater risk of being misdiagnosed, underdiagnosed, and undertreated for many diseases. This contributed to a large 46% spike in the gap in life expectancy at birth between the US black and white populations between 2019 and the first half of 2020.

We clearly have a systemic problem. Given that 80% of our well-being is determined by factors such as access to health care, physical environment, and lifestyle choices, how we invite patients—especially them—into the conversation must close this gap. We must show them that their health is their most valuable asset and encourage their participation as active participants in their health.

Richard Carmona, MD, MPH, former US Surgeon General, once told us a story that stuck with our team for years. As a young man, he served as an army medic in Vietnam, and got to visit the village of Montagard where many people desperately needed his services. However, when he tried to treat these sick villagers, Carmona saw them recoil in disbelief. For many days he did nothing but sit among the Montagnard people, listen to their stories, break bread with their leaders, and show them that he wanted to know them and their way of life. Finally, after gaining their trust, Carmona was allowed to practice his craft, and the results were immediate and positive. He prescribed penicillin pills to patients who needed them and then left, promising to return in a few weeks. When he did, he was greeted with fanfare and given a precious gift: a necklace containing all 40 penicillin pills he had left behind. The local leaders, smiling, told him that they put necklaces on the chests of sick patients, as their traditional approach to healing suggests.

For a while, Carmona considered the story a failure—after all, he had limited success in educating the Montagnard villagers on the workings and benefits of Western medicine. But he soon discovered that there was a deep, deep moral to his story: he was welcomed and trusted by the villagers, he felt, not because he was able to show clear and effective and demonstrable results, but because he took the time. Show them respect. He was there as a human being, connecting with other people, and this basic but all too rare approach made the villagers believe in him.

How can we apply these lessons in practice today? A simple solution is to include a more diverse workforce. For example, health systems can provide more appropriate and effective care when care team members speak the patient’s language and understand their sensitivities. The same is true for community partnerships: health care delivery models can be redesigned with a more holistic roadmap to include partnerships with non-health care organizations nationally and locally, with our overall health determined outside the narrow perspective of clinical care. A big difference in optimizing healthy behaviors and encouraging healthy lifestyle choices.

But the kind of radical empathy we need goes beyond broad organizational measures if we are to gain the trust of our patients and transform the way we deliver care. To improve our health care system, the entire medical community needs to fundamentally rethink how we approach our work.

Imagine a medical school class that teaches physicians not only good bedside manner, but also how to share their own stories of hardship and loss, and how to open up about their own failures and successes. Imagine medical education — and practice — focused on people meeting each other with empathy, compassion, and trust, rather than as two nodes in a highly impersonal and complex, transactional and monetization process. Such an approach would fly in the face of hundreds of years of medical history – but we cannot take this turn.

With more Americans sick than ever before, and our current cures failing to meet public health crises, the time has come to reduce life expectancy. It’s time to reignite the most powerful healing tool in our arsenal: human connection.

Jennifer Meares, MD, is the Chief Diversity and Inclusion Officer at Northwell Health. Elizabeth McCulloch, PhD, is assistant vice president for health equity at Northwell’s Equity of Care. They are co-authors of the book, Reviving the Human Connection: Pathways to Diversity, Equity and Inclusion in Healthcare.

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