Ask Your Patients if Kindness is Right for You: Kindness in Healthcare Providers

“The published literature suggests that physicians who display a warm, friendly, and reassuring manner with their patients are more effective… empathy makes patients more forthcoming about their symptoms and concerns, thus, facilitating medical information gathering, which, in turn, yields more accurate diagnosis and better care; helps patients regain autonomy and participate in their therapy by increasing their self-efficacy; and  leads to therapeutic interactions that directly affect patient recovery. In sum, “making connections” and developing empathy are fundamental to caring and enhance the therapeutic potential of patient-clinician relationships.” –Dr. Eric B. Larson and Dr. Xin Yao

by: M.T. Bennett

Inspired by the 20th anniversary of our sister organization, the Maliheh Free Clinic, we’ve been sharing about the intersection between healthcare and kindness. In our previous articles in this series, we showed how kindness can improve our physical and mental wellbeing. In this final article we want to write directly to healthcare workers and explore what happens when we practice the art of medicine with kindness.

Keep in mind, healthcare can be the kindest profession. Medical professionals do things that most people would not be willing to do for another person, let alone a stranger. Unfortunately, while healthcare professionals can be the kindest people, the field of healthcare can be very difficult place to work.

So, what can we do to help? Well, there are a myriad of problems that need to be addressed, and I don’t have enough hubris to believe this article will solve them all. However, I want to share one simple thing you can do today…kindness.

I’m not trying to say that healthcare workers are not kind. As I said, there are few people kinder. This is more reframing of one’s outlook. It is common in many service professions (such as healthcare, teaching, charitable work, etc.) to enter the workforce with dreams to “help people”, and then over time it becomes normalized, turns into “just a job”, and becomes mundane. It is really important in these industries to stop and reframe the work we’re doing. To see the kindness in our actions, and help patients feel our concern and compassion. Doing so will help you to be happier, help you provide good care, and help your patients be healthier.

How Kindness Helps Healthcare Workers

When you ask healthcare workers what the purpose of their work is you usually get answers like “treatment of disease” or “improvement of health”. One common answer is “reducing suffering”. This is a noble answer, however, we need to remember that we are trying to reduce the overall suffering of humanity. We don’t end up with a net decrease in suffering if we are trading a patient’s suffering for our own. We cannot draw compassion and kindness from an empty well.

Medical care is full of “burnout” or mental fatigue or emotional exhaustion from stress or difficult situations. With the COVID-19 pandemic we saw how stressful being a healthcare worker can be, and the effect of that time still lingers. A report from 2023 from 40,301 clinical staff showed alarming data. 49.9% of healthcare workers were experiencing burnout, and 28.7% expressed an intent to leave medicine. Think about that. One in two medical professionals admits feeling mental and emotional collapse, and one in three is making plans to change professions. I can personally say that burnout and temptation to leave medicine are very real and affect a lot of us.

Kindness to Co-Workers

In their book “Compassionomics”, Drs. Stephen Trzeciak and Anthony Mazzarelli talk about how “burnout was directly linked to compassion fatigue and depersonalization.” This led them on a journey to discover how caring, and compassion really do help. There is a plethora of research that shows that a little extra kindness in one’s medical practice goes a long way. One research study on a high stress emergency room shows that performing acts of kindness for one’s coworkers can help protect against burnout and compassion fatigue.

So, do a co-worker Secret Santa, restock the tongue depressors, talk to a peer who is struggling, pick up some bagels for the reception employees. Not only will it benefit your peers, but it will give you compassionate armor against the stressors of your job.

Kindness to Yourself

Numerous studies show that kindness should even be directed at oneself. Medicine is full of perfectionists and medical training can be a toxic place. When, as an impressionable 3^rd year medical student, you have your ENT attending berate your stupidity in front of colleagues and peers for not knowing the Arnold Ear-Cough Reflex, it is hard not to internalize that and continue to berate oneself for any mistakes or obscure gaps in knowledge.

Unsurprisingly, research shows that if we are able to halt these negative thought loops, we experience less stress and have lower measured cortisol. As we eliminate negative thoughts, we need to practice self-compassion which has been shown to protect against burnout. We need to not only be kind to our patients and coworkers, but we need to be kind to ourselves as well.

Let’s illustrate this with one last point. Roughly one in three medical students is experiencing moderate depression (be kind to your trainees) which is higher than the average population. However, research shows that medical students also score higher on empathy than the average person. How can this be? If empathy and burnout have an inverse effect, shouldn’t these abnormally empathetic students be at risk for mania not depression?

Well, as we’ve shown it isn’t enough to have empathy for others, you need to have compassion for yourself. It requires a balance, as demonstrated by one study on nurses which said, “High levels of affective empathy may be a risk factor for compassion fatigue, whereas self-compassion might be protective. Teaching self-compassion and self-care skills may be an important feature in interventions that aim to reduce burnout and compassion fatigue.” So, healthcare workers need to balance their superhuman levels of empathy for others with a little bit for themselves. Be kind to others and be kind to yourself.

Patient Benefits of a Kind Healthcare Worker

With all the advances in healthcare from medications, devices, implants, surgical procedures, etc.; all of this shouldn’t distract us from what has been the core of medicine since the first human bandaged another’s wound…the relationship between patient and caregiver. It is amazing how much good comes out of protecting this human connection.

How much of an impact does kindness have on this relationship? Well, let’s check it out.

Cure for the Common Cold?

One of the elusive myths in medicine is a cure for the common cold. There is no medicine one can take to heal a cold, so we mostly just prioritize symptomatic care. However, one study looked at 350 patients suffering from a cold and measured their outcomes. They found that patients who perceived their physicians as kinder and more empathetic, recovered from their cold faster.

About the efficacy of empathy they said, “the positive benefits of perceived empathy on the common cold can be put into perspective when compared to anti-viral studies showing similar modest effect sizes. In order for a drug to be beneficial for a self-limited illness such as the common cold, it needs to show efficacy, ease of dosing and few side effects. The best effect from a drug studied to date (pleconaril) also reduced the duration by about one day but worked only for picornavirus-associated colds and caused nausea and diarrhea. Empathy has a similar effect without side effects in all-cause colds and was found beneficial after only one dose of human empathy.” Essentially, the current best drug for the cold only works on one kind of cold and gives patients diarrhea. Kindness works on all colds and has no adverse effects.

So, next time you have to explain to a patient why prescribing antibiotics won’t help them with their Rhinovirus infection, you can feel good knowing that your kindness will.

Could Kindness Lower Malpractice Premiums?

No.

But it should.

Unfortunately, insurance companies are not set up to give an insurance break based on how kind your patients rate you. If they did maybe it would encourage physicians to avoid the Dr. House-paternalistic-jerk-style for a more compassionate collaborative caretaker.

In the amazing book “Compassionomics” the authors point out how important kindness is in preventing medical errors. They say that, “a health care provider who doesn’t demonstrate compassion didn’t just miss and opportunity to improve an outcome for his patients, but he or she is also more likely to harm a patient”. They go on to highlight two striking studies.

In one they found that doctors who scored high in depersonalization scored low in compassion and were at higher risk of performing a major medical error. Those in the highest rank of depersonalization were 45% more likely to commit a major medical error within the next three months than those in the lowest rank of depersonalization. Physicians who scored highest in emotional exhaustion were 54% more at risk for major medical errors.

In the other study which was done to validate the first, researchers found that doctors who scored highest for depersonalization had a 50% higher risk of committing errors. Those highest in emotional exhaustion were at a 63% higher risk. In “Compassionomics” the authors point out that “physician compassion was associated with lower odds of committing a major medical error”.

As medical professionals form connections, feel compassion, and demonstrate kindness they reduce the risk of harm to their patients. Have you ever heard that, “people don’t care how much you know, until they know how much you care”? This quote could be made to apply to healthcare. If decreased compassion increases the risk of harm, then patients should really look for doctors who connect and care. Every doctor passes the same board exams and certifications. They all have shown the competency and knowledge needed to heal, the thing that sets them apart now is if they have the ability to show kindness.

Kindness Can Heal Wounds

One of the saddest things I recall from working in medicine was wound care. Few wounds ever seemed to heal as fast as was desired and some, due to comorbidity and lifestyle, got worse. With that in mind, it is remarkable to think kindness can help wounds to heal faster.

One study induced blister wounds on couples and measured cytokine levels through the healing process. Couples were told to either interact in ways that were emotionally supportive or hostile. The researchers found that supportive couples’ wounds healed 17% faster.

Now you don’t need to fix marriages to get your patients to heal better. As a healthcare worker you make an impact just by showing up with kindness. Researchers have shown that something as simple as a kind and compassionate visit to preoperative patients can improve post-operative wound healing. They also found that patients who received empathetic care had less pain from the procedure and required less opioid medication to manage it.

More Health Benefits from Kindness

We’ve all heard of “White-Coat Hypertension”, where the setting of a doctor’s office induces anxiety and causes a patient’s blood pressure to measure higher than it would at home or a less stressful environment. Not surprisingly, your kindness can directly counteract high blood pressure as you make your clinic a safe and kind place.

In patients with diabetes, we often stress lifestyle changes to help alleviate complications. Oddly enough, research has shown that physicians can make a simple lifestyle change to help with their patients’ diabetes, just by being a little more kind. In a huge study of 20,961 patients, researchers found that patients who rated their physician as high in compassion had a 41% reduced risk of serious complications from their diabetes.

Trust in the medical profession has waned in the last few years. Thankfully, kindness can help! Healthcare workers go through a lot of training to become incredibly competent in providing care. Your patients might not care about all the certificates and diplomas on your wall as much as they care about your kindness. Researchers had patients be presented with identical medical information from physicians who had kind non-verbal behavior (eye contact, sitting at eye level, empathetic facial expressions) against physicians who had unkind nonverbal behaviors (arms crossed, annoyed expressions, of sat behind a physical barrier). Patients rated the kind-behavior-physicians as 15% more competent.

I could go on and on about the literature on the benefits of kind healthcare workers. There is incredible healing power in kindness. Both to yourself, your peers, and your patients.

Conclusion: The Prescription We All Need

The evidence is clear. Kindness is not a luxury in healthcare; it’s a necessity. It strengthens the caregiver-patient relationship, improves clinical outcomes, reduces burnout, and makes the often-overwhelming world of medicine just a little more humane. While we continue to seek new technologies, treatments, and systems to improve healthcare, we must not forget that one of the most powerful tools we possess has been with us all along: compassion.

Kindness doesn’t require an advanced degree, a new protocol, or an administrative directive. It’s something we each can choose in every interaction. From restocking a supply drawer for a tired colleague, to forgiving ourselves for not being perfect, to offering a warm smile and undivided attention to a worried patient, these simple acts accumulate into something profound.

So, ask yourself, not just as a healthcare worker but as a human being, is kindness right for you? The answer might just be the most healing one of all.

 

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