Guest: Dr. Thomas Lee
Presenter: Neal Howard
Guest Bio: Dr. Thomas Lee joined Press Ganey as Chief Medical Officer in 2013, bringing more than three decades of experience in health care performance improvement as a practicing physician, a leader in provider organizations, researcher and health policy expert. As CMO, Tom is responsible for developing clinical and operational strategies to help providers across the nation measure and improve the patient experience, with an overarching goal of reducing the suffering of patients as they undergo care, and improving the value of that care. In addition to his role with Press Ganey, Tom, an internist and cardiologist, continues to practice primary care at Brigham and Women’s Hospital in Boston.
Segment overview: Dr. Thomas Lee, Chief Medical Officer of Press-Ganey, a company that surveys hospital patients, discusses his very recent book, AN EPIDEMIC OF EMPATHY IN HEALTHCARE: How to Deliver Compassionate, Connected Patient Care That Creates a Competitive Advantage (McGraw-Hill; November, 2015), and how he uses insights from social network science on how to spread empathy to caregivers using techniques based on data and scientific studies.
Health Professional Radio – Patient Centered Care
Neal Howard: Hello and welcome Health Professional Radio, I’m your host Neal Howard. We’re in studio today with Dr. Thomas Lee who joined the Press Ganey as Chief Medical Officer in 2013. Press Ganey is a company that surveys hospital patients. And he’s also an author, the author of “An Epidemic of Empathy in Healthcare: How to Deliver Compassionate, Connected Patient Care That Creates a Competitive Advantage” published by McGraw-Hill November of 2015. He is here today with us as a returning guest to talk about the need for an environment where patients are tended to and priority one for doctors, nurses and clinicians. Welcome to the Health Professional Radio today Dr. Lee, how are you doing today?
Dr. Thomas Lee: Very well, thank you for having me.
N: You’re the author of An Epidemic of Empathy in Healthcare, you’re also the Chief Medical Officer of Press Ganey. You’re with the company that surveys hospital patients, getting their opinions, finding out what they like, what they don’t like, how they think that their care, their experience can be made better. Is this something that you were always involved in? Thought about when you were in medical school or is this something that formulated in your mind as you saw the experience of patients pretty much deteriorate over the years?
L: It’s interesting and Press Ganey has been evolving as have I and Press Ganey does much more than collecting information from hospital patients. There are patients on the outpatient sector, patients having outpatient surgery and every setting and we also collect other kinds of data. But really what we’re about is the same thing that I hope I’ve been about in most of my career which is trying to make the healthcare system work, trying to make it better in meeting patients’ needs and the chance to have something to say about what gets measured and how that information gets sent back. That seems to be a pretty good way to have impact on a big scale so that what’s sort of led me to where I am today.
N: It seems to me a little bit contradictory, here you on the one hand working hard to improve the experience of the patient as far as being empathetic and putting yourself in the situation of the patient. But telemedicine which seems to further separate while being convenient, it seems to kind of drive a further wedge between that closeness, that connection between patient and physician. What are your thoughts of telemedicine in general?
L: Well I know that we’re goanna be figuring stuff out as we go along and that what my kids are going to want from healthcare is different from like what my mother wants. But it’s very clear that people want contact, they want to be able to trust that they’re going to reach someone who can help them when they need help. And it’s great to have someone face to face with me, it’s great to have a chance to touch them and let them touch me, so they know that there’s real contact going on. But a lot of times that’s not the best way to get things done so before we got on the call with you I was doing electronic communications with patients and I was sending out some of the answering their queries, others I was just sending little message saying “Just checking in, how are things going.” And that kind of little checking so they know that I and the healthcare system I work in are thinking of them, worrying about them, are there for them, that’s the kind of thing that’s frankly makes them feel loved and makes them more likely to stay with us and also it makes their care better.
N: Talk about levels of empathy. You have a hospital that’s been there for many, many years, you have a medical practice down the street, you’ve got an urgent care center a couple blocks from there and you’ve got a hospice home around the corner. Are we talking about being empathetic in levels? Because some of these practices are set up to get you triage to get you out and on to the next one. You don’t have time to actually feel.
L: Well I think that we’ve done a lot of research with my colleagues at Press Ganey looking at real data and it’s extraordinary actually. What we’re finding is that in every setting, patients value the same things. What they want is they want good clinicians, they want them to be working well together, they want team work, they hate poor coordination of care. They want the feeling that people care about them, and then they want good communication about what’s happening. And after you take those things into account, what we found is that waiting time actually does not matter to the patient as a driver of their likelihood or recommending a doctor or a hospital or an emergency department. Pain control doesn’t matter, your patients aren’t expecting zero waits, they’re not expecting zero pain but what’s they’re hoping for is it someone cares about them and whose gonna listen to them, whose gonna talk to them. And I think that in every setting that is important, actually focusing on the patient, taking note what’s important to them, telling them what’s going on. And that doesn’t take hours, it does take energy and mustering the energy for that emotional labor – that’s a lot of what we have to try to make happen systematically.
N: As a physician yourself, have you heard of any of your colleagues transitioning to concierge medicine for this particular reason so that they can have more time and more of their own resources to enhance the patient experience and offer better care?
L: Oh sure. I’ve had some of my friends move into concierge practices and I’ve had some my friends leave medicine because they felt that the pay and demands were not what they could thrive with and so on. And I think that I don’t fault any of them, their choices. But I don’t really think that the concierge practices are systematically more empathic than the care where I practice, where my visits are 15 minutes for a return visit, routine depends on how my schedule is. And I don’t think the patients are systematically happier and I think the clinicians are systematically happier in that concierge setting.
N: You frequently lecture on the patient experience and strategies for improving the value of healthcare. When you’re talking to a hospital’s administrative staff or a student body, do you ever focus on maybe the importance of specializing when it comes to your empathy? Say if you’re a pediatrician, if you’re going to pediatrics as opposed to geriatrics, empathy isn’t all inclusive, one size doesn’t fit all.
L: Well the truth as the matter is there are things that we can learn from colleagues and other disciplines and including non-healthcare disciplines. But for example like the pediatric folks, they know some staff that in adult medicine ought to imitate, like they routinely open their rounds in the ICU’s to patient’s families. They don’t exclude them, they say “Come join us on rounds.” They do things like when a child dies and a lot of hospital like one year later they’ll have a ceremony, they invite the family back and the clinicians, the doctors, nurses who took care of the patient, meet in the room and they just sort of honor the memory of the child who died, and it’s not just for the family to bring a certain closure for the clinicians. So these are things that are going on in pediatrics, now could we imitate things like that in adult medicine? Could we have good family meetings the way they have in pediatrics? I think in geriatrics we ought to be having this kind of family meetings all the time. So we can learn from each other and learn from other disciplines.
N: Now in your book An Epidemic of Empathy in Healthcare: How to Deliver Compassionate Connected Patient Care that Creates a Competitive Advantage, how much do you address the patient experience? Not necessarily the empathy of the physician but how a patient appreciates the technical expertise? How the patient appreciates the training that the physician has had, how they appreciate them being a doctor sometimes as opposed to being a buddy?
L: I think that there’s definitely a lot to what you’re saying and I don’t think that patients come to see me because they want me to be their friend. They don’t necessarily want to be taken care by someone who might be sitting at the next bar stool watching the football game. They want to have someone they can trust and that’s why being in healthcare is such a very special responsibility – patients want to trust you. And then you better earn that trust, you better be as reliable in your excellence, in your safety, and your coordination, the way you work with your colleagues so that they can have confidence that thing are as good as they can be. It’s a special respect that you get in healthcare and I think we have to earn it.
N: You’ve been listening to Health Professional Radio, I am your host Neal Howard. We’ve been in studio this afternoon talking with Dr. Thomas Lee, Chief Medical Officer of Press Ganey and also the author of “An Epidemic of Empathy in Healthcare: How to Deliver Compassionate, Connected Patient Care That Creates Competitive Advantage.” Tom holds a bachelor’s degree in history and science from Harvard College, a Medical Degree from Cornell University Medical College and a Master’s Degree in Epidemiology from the Harvard School of Public Health. And he’s been here with us discussing the importance of creating environments where patient are tended to and become priority one and remain priority one among doctors, nurses and clinicians. It’s been great having you here with us today Dr. Lee.
L: My pleasure, and it’s been fun for me too.
N: Transcript and audio of this program are available at healthprofessionalradio.com.au and also at hpr.fm and you can subscribe to our podcast on iTunes.