— BOOK AND MEDIA REVIEWS —

Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference

Esther Strahan, PhD

Fam Med. 2020;52(6):454-455.

DOI: 10.22454/FamMed.2020.543600

Book Title: Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference

Authors: Stephen Trzeciak, Anthony Mazzarelli

Publication Information: Pensacola, FL, Studer Group, 2019, 375 pp., $18, paperback

I’ll admit I wasn’t excited when a colleague first told me about Compassionomics. Sure, we need to relate well to our patients; what’s new about that? I reluctantly picked up the book because I respect the colleague, but I didn’t have high hopes for it.

Despite my lukewarm start, reading Compassionomics was a great pleasure, and now I’m the one recommending it to colleagues. What Stephen Trzeciak, MD, MPH, and Anthony Mazzarelli, MD, JD, MBE, have accomplished is to make the topic of compassion in medicine engaging, show how it relates to patient and financial outcomes, and dispel fears that engaging compassionately with patients will take a lot of time and energy.

Trzeciak is a practicing intensivist and an NIH-funded researcher who has published widely in the area of resuscitation science. He is a professor and chair of medicine at Cooper Medical School in Camden, New Jersey. Mazzarelli continues to practice emergency medicine, and he also earned a law degree, and a master’s degree in bioethics. He is currently copresident and CEO at Cooper University Health Care.

The book is organized in three main sections, the first of which is “The Case for Compassion.” Starting with a story about a bus crash on a snowy road in Sweden, the authors describe how researchers learned, 5 years after the accident, that the survivors’ primary memories of the incident were not only of the physical pain they endured, but also the lack of compassion they felt from the caregivers once they arrived at the hospital.1

The authors then build a compelling case that our current health care system is plagued by a lack of compassion, citing studies from across medical disciplines. For instance, they describe research from a University of Chicago study that found primary care physicians missed 79% of emotional cues from patients that indicated a need for a compassionate response.2 They also describe a Johns Hopkins ICU study that found 74% of health care providers showed no evidence of compassion for patients or families.3

The second section, “Compassion Improves Outcomes for Patients,” examines research showing that medical outcomes, parasympathetic responses, psychological well-being of patients, self-care by patients, and even patients’ sense of purpose, are all affected by physician compassion. A striking example studied 370 patients in a primary care setting. The researchers found that the strength of the doctor-patient relationship was associated with a 34% increased likelihood of the patient adhering to prescribed medications.4

The third section, “Beyond Patients,” examines how compassionate care increases hospital revenue, cuts costs, and how even physicians who are not naturally warm and intuitive can learn to demonstrate compassion. They cite a study showing that compassionate care needn’t take long; 40 seconds can make a huge difference in patient care. This number comes from a Johns Hopkins study of breast cancer patients that found reduced anxiety in patients when the oncologist simply said a few reassuring words, including “I know this has been a tough experience to go through and I want you to know that I am here with you. We are here together, and we will go through this together. I will be with you each step along the way.”5

Strengths of Compassionomics are, first and foremost, its focus on the science of compassion in health care. The authors have done a masterful job of interweaving material that appeals to the head with stories that speak to the heart. The style is engaging and conversational, and the patient stories are compelling. Personal experiences of the authors, and stories about physicians in crisis will also resonate with readers. The intended audience is health care providers and administrators, but educated lay people will also appreciate its accessibility.

There are a few areas for improvement, most notably the need for an index. Also, the authors coined the term “compassionomics.” It’s catchy, but does not represent a revolutionary new field, as research on the impact of the provider’s relationship with the patient is not new. At times, the reader may begin to feel that the case has been made, and one might dispense with yet another example of the crucial role of compassion in health care.

However, the examples create a logical flow as the authors build their case, and the book is excellent and very readable. I can easily see why The Scientist Magazine listed Compassionomics as one of its “Best Neuroscience Books of 2019.”6 I recommend it for everyone from residents to seasoned physicians interested in learning how to be the most effective and engaged clinicians they can be.

References

  1. Doohan I, Saveman B-I. Need for compassion in prehospital and emergency care: a qualitative study on bus crash survivors’ experiences. Int Emerg Nurs. 2015;23(2):115-119. 
  2. Levinson W, Gorawara-Bhat R, Lamb J. A study of patient clues and physician responses in primary care and surgical settings. JAMA. 2000;284(8):1021-1027. 
  3. Carrese JA, Geller G, Branyon ED, et al. A Direct Observation Checklist to Measure Respect and Dignity in the ICU. Crit Care Med. 2017;45(2):263-270. 
  4. Kerse N, Buetow S, Mainous AG III, Young G, Coster G, Arroll B. Physician-patient relationship and medication compliance: a primary care investigation. Ann Fam Med. 2004;2(5):455-461.
  5. Fogarty LA, Curbow BA, Wingard JR, McDonnell K, Somerfield MR. Can 40 seconds of compassion reduce patient anxiety? J Clin Oncol. 1999;17(1):371-379. 
  6. Dolbow J. Opinion: The best neuroscience books of 2019. The Scientist. https://www.the-scientist.com/news-opinion/opinion--the-best-neuroscience-books-of-2019-66863. Published December 18, 2019. Accessed January 21, 2020.

Lead Author

Esther Strahan, PhD

Affiliations: St Rita’s Family Medicine Residency, Lima, OH

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