Compassion is competence: the key to successful patient care

compassion in medicine
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As a field training officer and adjunct EMS lecturer, I have the opportunity to work with both rookies and seasoned professionals.  While their levels of expertise are obviously different, there is something that matters to both groups: competence.  Those who are new to the field are so focused on demonstrating their practical skills to themselves, their colleagues, and their patients that they forget the urgency of bedside manner.  Experienced providers, no longer feeling the need to prove themselves, often work quickly and diligently as they easily navigate their protocols and algorithms yet they forget to explain procedures to the patient or to communicate their expectations of how a scene should be managed to their lesser experienced partners.  EMS professionals on both ends of the spectrum have forgotten that competency alone will not guarantee success.

Psychologists and sociologists have learned that professional success is not solely determined by competence, but also warmth.[1]  In only milliseconds, our patients (and also, our partners) will develop their impressions of us and those impressions are based upon the warmth we demonstrate to others.[2]  Our concerns may be scene safety, proper performance of our skills, rapid transportation, and ending our shifts on time, but our patients are concerned about how they are being treated and the outcome of their care.  When citizens call 911, they believe that the government has dispatched providers who are highly qualified.  Our uniforms, emergency vehicles, and equipment already imply competence.  If we want our patients to have a positive experience during our care and simultaneously display our proficiency, we must first integrate warmth.  When we are perceived as pleasant, polite, and concerned, we open the door for others to trust that we are competent.

What are three steps that we can take to introduce warmth to our care?  Firstly, practice active listening.  When we are able to reflect upon what others have said, ask open ended questions and then respond to specific answers, summarize our patients’ concerns, and affirm their needs and desires, we will be much more effective practitioners.  Secondly, we need to start smiling.[3]  Many of us arrive on scene as if we’ve arrived at a funeral, but our patients are not dead yet.  Even if the patient’s condition is critical, we can still offer a smile.  Their situation may be serious, but we can bring calm dignity during grave moments.  Thirdly, explain the procedures and processes that are about to happen.  I cannot tell you how many unsettled faces I’ve seen when the electric stretcher starts going up in the air without warning.  Minimize surprises and clarify what may be unknown to the patient.  If we can do these three things on our calls, our competency will rarely be called into question.

Dr. House may be great entertainment, but in the real world of medicine he would have been assigned to the lab a long time ago.


[1] Christine Horvath, Mastering Civility: A Manifesto for the Work Place (New York: Grand Central, 2016), 71.

[2] Ibid., 72.

[3] Ibid., 72-73.