How The Human Connection Improves Healthcare

[Music]

[Applause]

i wanted to be a doctor since i was six

years old

the human body fascinated me i watched

in awe

on tv and in the movies as doctors

performed these life-saving procedures

i entered medical school with a deep

desire to learn everything that i could

about the science of medicine

and how the human body worked but then

something happened to me

that made me realize that health care

was really broken

and gave me a new perspective on what

medicine was really about

it was the summer of 1996 i was just

completing my training

when i received a late evening phone

call from a desperate physician

to pick up an extremely sick newborn you

see the baby had a condition and his

only chance of survival

was to be placed on a heart lung bypass

machine immediately

when the team and i arrived we found a

critically ill baby

desperately clinging to life the parents

gave their son a quick kiss on the cheek

and off we went into the ambulance

lights and sirens blasting

by everyone’s estimate there wasn’t much

time

the ventilator was struggling to keep

the blood oxygenation levels up

and despite everything that we can do

the blood pressure and heart rate

continuously dropped

by the time we got back to my hospital

we were in full resuscitation mode

including cpr

but sadly time ran out and the baby died

it wasn’t much after that that the

charred nurse informed me that the

father had followed the ambulance and

was anxiously waiting for me in the

waiting room

completely unaware that his son had just

died

now the senior physician in charge that

night

was someone that i greatly admired let’s

for the sake of confidentiality call him

dr cunningham tim as everyone knew him

was the smartest kindest and most

compassionate doctor i had ever known

the kind of doctor that i wanted to be

like someday

i saw that tragedy that night as an

opportunity to learn a life lesson

you see although i was very confident in

my clinical abilities as a doctor

the thought of telling someone tragic

news still scared me to death

i mean how do you tell somebody that

their baby died

i thought who better to learn from than

dr cunningham

so together tim and i walked down the

hallway towards the waiting room we

opened up the door to find a father who

was frantically pacing back

and forth and then what happened next

was and still is decades later

inexplicable to me this kind

compassionate doctor that i had grown to

admire

simply blurted out my name’s dr

cunningham

your baby died

well the father he went crazy i remember

he punched a hole in the wall he knocked

the table lamp

over and he made a scream and a sound

that i had never heard before

after a few moments of discussion and

what seemed like hours of crying i took

the father to see his son

i spent a few minutes with him and then

i left him alone

when i walked back out into the hallway

dr cunningham was waiting for me

he grabbed me by my shoulders and he

pulled me in really close

and i can see that there were tears in

his eyes

and he said to me in this quivering firm

voice

do you see what i just did don’t ever

do that and he turned around walked down

the hallway onto the fire escape and

spent the next 20 minutes crying

you see i realized that night medicine’s

not about science or technology

medicine’s not just about how smart or

skilled you are as a physician

it’s not even about how kind you are as

a person

at its core medicine is about that human

to human interaction between a patient

and a doctor it’s about the ability to

convey your compassion

regardless of whether you’re delivering

tragic news or you’re meeting a patient

for the first time

but somehow we got away from that in the

united states alone we spend trillions

of dollars each year on health care and

the costs are steadily increasing

advances in medicine have led to

state-of-the-art diagnostic tools

and life-saving procedures and drugs

that were unimaginable just a few

decades ago

yet studies still show that a

significant number of patients

are still unhappy with their medical

provider

in a recent internet survey that we

performed

71 of patients who responded stated that

they often felt a lack of compassion

from their doctor

73 percent stated that they frequently

left the hospital

or doctor’s office feeling rushed and

without all their questions being

answered

and an amazing 39 percent stated that

they had such a bad interaction

that it led them to change providers

the system’s just not working medicine

has become more and more about increased

documentation electronic medical records

and maximized efficiency doctors and

nurses

are being asked to do more and more work

in less and less time

professional burnout among doctors and

nurses is at an

all-time high and did you know

that doctors now have the highest rate

of suicide of any profession

this has unknowingly and unwillingly

caused us to become task oriented

instead of what we should be

patient oriented the good news is

that together you and i we can begin to

fix health care right now

not by spending loads of money but by

simply getting back

to what really matters did you know that

a patient

who feels a connection with their doctor

even if they met them for the first time

is more likely to take their medicine

more likely to follow up and yes have

better treatment outcomes

that’s why a medical provider’s ability

to communicate and build trust

is more important than ever so as a

doctor

how do i begin to build that trust well

it starts off by first

being a relatable person and a doctor

second

you know my mother used to say to me all

the time she used to say anthony

it’s hard to fire your best friend no

matter how successful i became she’d

constantly remind me she’d say

don’t forget it’s hard to fire your best

friend

i used to think why is my mother always

so afraid i’m going to get fired

it wasn’t until much later that i

realized what she was saying

in her own way my mother was telling me

to be nice to everyone

but more importantly she was telling me

to get to know everyone

not just on a professional basis but on

a personal level as well

it’s so important for doctors and nurses

to take just a few minutes to get to

know their patients each and every time

and build rapport

because once rapport is built trust will

follow

systems they’re designed for the masses

but medicine only works when doctors can

treat patients

as people one at a time

good health care starts and ends with

good communication

so if you’re a doctor and you’re feeling

rushed maybe becoming task oriented just

stop

recognize it sit down put your laptop

aside and just

get to know your patient imagine that

you’re the patient

put yourself in their shoes and your

natural compassion will just flow

because

once you can connect as two relatable

people

or as my mother would say as best

friends

that’s where medicine works its best

now you might be asking what can i do as

a patient to make sure i get the very

best health care

well the most important thing is to know

that your health care is more important

than any system you control your

healthcare because you

can control the conversation it’s okay

to expect that personal connection

with every doctor or nurse that you meet

even if you met them for the first time

so here’s the secret

next time you go to the doctor or the

hospital unless it’s an emergency

don’t talk medicine share something

personal first

if your doctor seems preoccupied or

rushed

that’s okay ask them how their day’s

going

tell them about a recent vacation you

went on and asked them if they’ve had a

recent one

ask them if they saw the game yesterday

i’ll be willing to bet that if you do

that

you’ll see your doctor relax perhaps

even smile

once you can connect and build that

commonality

the conversation will go so much better

we have a choice we can continue on this

path

to impersonal health care or we can get

back to what really matters

a trusting relationship between two

relatable people with one goal in mind

your health thank you

[音乐]

[掌声]

我从六岁起就想成为一名医生

人体让我着迷 我

敬畏地看着

电视和电影中的医生

进行这些挽救生命的手术

我怀着深深的

渴望进入医学院 尽我所能

了解医学科学

以及人体如何工作,但后来

发生在我身上的

事情让我意识到医疗

保健真的被打破了,

并让我对

医学的真正意义有了新的认识,

那是 1996 年的夏天 我刚刚

完成培训,就

在深夜

接到一位绝望的医生打来的电话,

要接一个病得很重的新生儿

。 我和团队赶到了,我们发现一个

病重的婴儿

拼命坚持生命父母

给了他们儿子的脸颊一个快速的吻,

然后我们进入了救护车

灯和警报器

根据每个人的估计

,呼吸机没有太多时间努力

保持血液氧合水平

,尽管我们能做的一切,

但当

我们回到医院时,血压和心率持续下降,

我们正在完全复苏

包括心肺复苏的模式,

但遗憾的是时间用完了,婴儿死

了没多久,

烧焦的护士告诉我

父亲跟着救护车,

在候诊室焦急地等我,

完全不知道他的儿子刚刚

死了

现在当晚的主治医生

是我非常钦佩的人

,为了保密起见,我们称他为

坎宁安·蒂姆医生,因为每个人都知道他

是我所知道的最聪明、最

有同情心的医生

我想成为的那种医生

就像有一天

我看到那天晚上的悲剧是一个

学习人生课程的机会,

尽管我对

自己的临床能力非常有信心 作为一名

医生,一想到要告诉别人悲惨的

消息,我仍然害怕得

要死 我们

打开门,发现一位父亲

正在疯狂地来回踱步

,然后接下来发生的事情

是几十年后仍然

让我无法解释的这位

慈悲的医生让我越来越

钦佩,

只是脱口而出我的名字,坎宁安医生,

你的孩子死了

好吧,父亲,

他发疯了

父亲去看他的儿子,

我和他呆了几分钟,然后

当我回到走廊时,我让他一个人呆着,

坎宁安博士正在等我,

他抓住我的肩膀,然后

我把我拉得很近

,我看到他眼里含着泪水

,他用颤抖的坚定声音对我说,

你看到我刚刚做了

什么,从来没有那样做,他转身

沿着走廊走到 逃生,

接下来的 20 分钟一直在哭

你看,我意识到夜间医学

与科学或技术

无关 医学不仅仅是关于

你作为一名医生有多聪明或熟练,

甚至不在于你作为一个人有多善良

,医学的核心是 关于

病人和医生之间的人与人之间的互动,

它是关于

传达你的同情心的能力

,无论你是在传递

悲惨的消息还是你

是第一次见到病人,

但不知何故,我们在

联合 仅在各州,我们

每年就在医疗保健上花费数万亿美元,

而且成本在稳步上升

医学的进步带来

了最先进的诊断工具

和挽救生命的程序和

药物 几十年前还无法想象,

但研究仍然表明,

在我们最近进行的一项互联网调查中,相当多的患者仍然对他们的医疗服务提供者不满意,其中

71 名患者回应说

他们经常感到医生缺乏同情心

73 % 的人表示,他们经常

感到匆忙离开医院或医生办公室,

而且他们的所有问题都没有得到

回答

,令人惊讶的是 39% 的人表示

他们的互动非常糟糕

,以至于导致他们更换供应

商 更多关于增加

文档电子病历

和最大化效率医生和

护士

被要求在越来越短的时间内完成越来越多的工作

医生和护士的职业倦怠处于

历史最高水平,您是否

知道医生现在拥有最高的

任何职业的自杀率

这在不知不觉和不情愿地

导致我们成为 一些以任务为导向,

而不是我们应该以

患者为导向的好消息是

,你和我现在可以开始

修复医疗保健,

而不是通过花费大量金钱,而是通过

简单地

回到真正重要的事情上,你知道

一个病人

即使他们第一次见到他们,他们也感觉与他们的医生

有联系更有可能服用他们的药物

更有可能跟进,是的,有

更好的治疗结果

这就是为什么医疗提供者的

沟通和建立信任的能力

比以往任何时候都更重要 所以作为一名

医生

,我如何开始建立这种信任

,首先

要成为一个有关系的人,然后是一名医生

无论我变得多么成功,她都会

不断提醒我,她会说

不要忘记解雇你最好的朋友很难

我曾经在想为什么我妈妈总是

那么害怕我会被解雇

它是 直到很久以后,我

才意识到她

用她自己的方式在说什么,我妈妈告诉我

要对每个人都好,

但更重要的是,她告诉我

要了解每个人,

不仅仅是在专业基础上,而是

在个人层面上

同样重要的是,医生和护士

每次都花几分钟时间了解他们的病人

并建立融洽的关系,

因为一旦建立融洽的关系,信任就会

遵循

为大众设计的系统,

但医学只有在医生的情况下才有效 可以

一次一个人对待患者

良好的医疗保健以良好的沟通开始和结束

所以如果你是一名医生并且你

感到匆忙 可能会变得以任务为导向

停止

识别它 坐下 把你的笔记本电脑

放在一边,

然后去了解 你的病人想象

你是病人,设

身处地为他们着想,你

自然的同情心就会流淌,

因为

一旦你能像两个有关系的人那样联系起来,

或者就像我妈妈所说的那样

这就是医学发挥最佳作用的地方

现在您可能会问作为患者我可以做些什么

来确保我得到

最好的医疗

保健最重要的是要

知道您的医疗保健

比您控制的任何系统都更重要

医疗保健,因为你

可以控制谈话,即使你是第一次见到他们,也

可以期待

与你遇到的每一位医生或护士的私人联系,

所以这是

你下次去看医生或医院时的秘密,

除非是紧急情况

如果您的医生似乎全神贯注或

匆忙

请先分享一些私人信息 昨天

我愿意打赌,如果你这样做

你会看到你的医生放松,

甚至微笑,

一旦你能够建立联系并建立这种

共性,谈话就会变得更好

我们有一个选择,我们可以继续走这

非个人的医疗保健之路,或者我们可以

回到真正重要

的两个相关的人之间建立信任关系,

并牢记一个目标,

您的健康谢谢