Compassion is more often on billboards than at bedside

Commentary. By Charles Atkins, MD, AMNews contributor. Jan. 15, 2001.

COMMENTARY

Observations on the state of medical practice and medical life

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Over the years, snippets of dialogue have taken on great meaning for me. These usually are truisms dropped in daily conversation. Frequently they are cautionary in nature.

One example came from a supervisor I had when I was in medical school. I had just told her about a night out with some of my classmates, to which she commented, "Oh, right, I remember when I used to have friends." She then went on to explain how after medical school her work consumed more of her time, she got married, had kids and "there just isn't the time for friends."

Recently, another one of these time-related poison pearls fell into my lap. It was at a symposium on Medicare compliance and documentation. The speaker was reviewing various components of the evaluation and management note. A physician in the audience asked about time, and how could he possibly write down everything? To which the speaker replied, "I do it right as the patient is talking; it's more efficient."

A discussion ensued about quality of care, and whether patients really want to come and see the physician, only to be met by the top of a head as he or she scribbles a note. What about human contact? What about compassion and the doctor-patient relationship? The speaker's response, paraphrased, was, "I no longer have time for empathy. It's not included."

This loss of caring and compassion has been a theme I've seen repeated in a variety of settings. A couple weeks back an older friend of mine was hospitalized. Although many of the nurses, doctors, etc., were quite kind, there was also an institutionalized callousness that set the tone of her stay. [...]