Why physician need "right" compassion

[drusso]

http://www.nytimes.com/2015/12/26/o...needright-compassion.html?mwrsm=Facebook&_r=0

Written from the point of view of a ER doc, but I think it applies perfectly to pain medicine:

"If physicians are to be effective in relieving suffering, a balance needs to be found between paucity and excess of empathy: Aristotle might have called it “right compassion.” Perhaps awareness of the risks of burnout, and disseminating knowledge of alexithymia, could help promote this balance."

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[Disciple]

I'd be interested to hear from the ex-ER doctors, emd123 and ducttape, in regard to dealing with the public, which has been more difficult,

ER or Pain Mgmt?

 

[Gauss]

compassion is defined as 5/5 on press ganey. <5 means you are inadequately displaying appropriate levels of compassion

 

[101N]

compassion is defined as 5/5 on press ganey. <5 means you are inadequately displaying appropriate levels of compassion

Lynn Webster/Bob Tillman's compassion formula: Compassion = MED

 

[Ducttape]

Truth be told, i dont really understand the point he is trying to make.

As an ER doc, one can be compassionate or dispassionate, towards a particular individual or situation, but that in no way abrogates or alters what a doctor should do - medical care is provided for specific clinical conditions irrespective of social circumstances.

Do something different/go an extra mile/ not do something - because you sympathize (or not) with someone? Treat someone different because you feel sorry for them? Or not act because they are of different race/class/social norm? If they are in the ER, they all need help...

I always felt my duty to provide care outweighed any feelings i might have about how or why these unfortunate individuals got there.

 

[drusso]

Truth be told, i dont really understand the point he is trying to make.

As an ER doc, one can be compassionate or dispassionate, towards a particular individual or situation, but that in no way abrogates or alters what a doctor should do - medical care is provided for specific clinical conditions irrespective of social circumstances.

Do something different/go an extra mile/ not do something - because you sympathize (or not) with someone? Treat someone different because you feel sorry for them? Or not act because they are of different race/class/social norm? If they are in the ER, they all need help...

I always felt my duty to provide care outweighed any feelings i might have about how or why these unfortunate individuals got there.

I think that point is the following: You ever meet people in Medicine who are a$$holes and ask yourself, "What admission committee thought that they were a "good fit" for this job? The sort of person "on the spectrum" in terms of Asperger's/Alexithymia. It seems that the medical field sort of attracts them in droves...the very "left-brained," low EQ type... Not unexpectedly, when you take people like this and put them in high stress/emotionally demanding work they sort of burn out... "This is an important condition for physicians to understand because it has a high correlation with depression, eating disorders, post-traumatic stress and anxiety. Alexithymic people can be difficult to treat with talking therapies: If you’re unable to imagine the emotional landscape of others, you’re often inarticulate with regard to your own." I run into a lot of alexithymic types in medicine...they mostly end up as desk-jockeys, medical directors, etc...

 

[Jitter Bug]

The medical care should be the same whether we like 'em or not. But how much empathy we have can affect whether we stay in the game, take up recreational alcoholism, or become a soulless administrator. Too much empathy is just as destructive as too little. Too much empathy can lead to letting the patient steamroll the doctor into poor decisions.

 

[emd123]

I'd be interested to hear from the ex-ER doctors, emd123 and ducttape, in regard to dealing with the public, which has been more difficult,

ER or Pain Mgmt?

ER was way worse, more burnout inducing and more soul crushing. Why? You deal with the same patients: Only worse because they're the ones ejected from Pain practices, they're drunk, you're seeing them at 3:30 am on a Saturday, while managing critical patients, with the Ems radio chirping that a multiple trauma is en route. Then you get sh¡t on by your director the next day (dead tired after being up all night) because wait times were 2 minutes too long for non-urgent patients, and your pay is getting docked because you didn't give roxi 30s to the stoned toothache that came by ambulance at 4 am, 'cause he didn't have a ride. Then, as you drive home post night shift, you nearly fall asleep at the wheel 10 times due to sleep derivation, despite rolling the windows down, turning the radio up to eleven and repeatedly pinching yourself on the neck to stay awake. It's very hard to be compassionate to anyone but the least fortunate under these conditions, especially considering so much of the insanity in the ER is either non-emergent nonsense that shouldn't even be there, or if emergent, often self-induced and/or stupidity induced.

There's no comparison. ER is much worse.

 

[Disciple]

Interesting how it seems to be in high demand with medical students right now.

Sign of the times? or they don't know any better.

 

[Ducttape]

I didnt think it was all that bad. Maybe because i have whatever disorder drusso is talking about?

My mantra had always been that s%}t happens, so what do we need to do now?

And the nonclinical time could always be so enjoyable, if done correctly.

I guess i would still be doing ER if i was valued by ER profession. 15 years, no adverse M&M cases, never sued (yet heh), no patient complaints i know of...

Oh well...

 

[emd123]

Interesting how it seems to be in high demand with medical students right now.

Sign of the times? or they don't know any better.

They don't know any better, and EM always sells well because of the "saving lives" and "be a hero" factor they sell. They also sell the aspect of working fewer days a month, and by the time you find out that working 30 hr per week in EM, takes the toll of doing 60 hrs doing anything else, it's too late to change. EM will always be popular going in, but will always be a high-burnout doctor-grinder on the back end. I'm sticking with Pain, and have never looked back. The grass is greener on this side, in my opinion, and from my perspective.

 

[emd123]

I didnt think it was all that bad. Maybe because i have whatever disorder drusso is talking about?

My mantra had always been that s%}t happens, so what do we need to do now?

And the nonclinical time could always be so enjoyable, if done correctly.

I guess i would still be doing ER if i was valued by ER profession. 15 years, no adverse M&M cases, never sued (yet heh), no patient complaints i know of...

Oh well...

If it wasn't bad you'd still be doing it. And the fact that you felt un-valued is an indication it was bad. I got more gifts, cookies, thank you notes last week than in 10 yrs in the ED. So I know what you mean about not being appreciated in the ED. I'm more likely to get a hug now in Pain for injecting a knuckle, than I was saving a life in the ED. #Fact.

 

[Promethean]

Interesting how it seems to be in high demand with medical students right now.

Sign of the times? or they don't know any better.

Yeah, what is up with that? I do not understand that at all. But both of the actual sabotage-your-classmates gunners that I've met have been crazy hot for EM, like anything else would be total failure.

EDIT: On reflection, it is probably just an extension of their over-the-top, always-gotta-have-something-to-brag-about-to-cover-up-for-secret-insecurities personalities. But still, it seems that a lot of people in my class are seriously considering EM as first choice.