How Positive Psychology Can Help Put The “Care” Back In Healthcare
Throughout my career, I’ve been fascinated by clinical successes that have nothing to do with medical treatment. For example, how is it that a subset of injured Army officers, upon hearing that their X-ray results are normal, have immediate and almost supernatural recoveries? Or, why did every one of my Haitian patients, following the 2010 earthquake, seemingly leave after treatment with a wide-eyed smile despite my ability to offer only rudimentary interventions in substandard medical conditions?
We know that nonclinical factors, or what some call bedside manner, are premier influencers of clinical outcomes. Nevertheless, providers tend to focus excessively on techniques and proven interventions while overlooking the so-called “soft skills,” like empathy, communication, and listening. They rush from patient to patient, consulting charts, offering diagnoses, and prescribing treatments, while every day, their actual time spent with patients is decreasing. All too often, practitioners prioritize treatment over care.
The field of “positive psychology,” which investigates the positive aspects of human experience, shows why that is such a crucial mistake.
Care: the missing element
Maybe it sounds like I’m being too harsh about healthcare today. But most healthcare professionals would agree with me. In a 2014 survey of more than 20,000 physicians, over half were pessimistic about the future of healthcare. Fifty-five percent described their professional moral and feelings about the state of the medical profession as negative, and they pointed out that paperwork alone consumed twenty percent of their time.
It’s little wonder, then, that kind, compassionate, and positive care has received so little emphasis. When doctors are unhappy and burned out, dehumanization and depersonalization are quick to follow. Evidence suggests that care is greatly lacking—particularly with respect to listening and communicating.
For example, a Canadian and US study found that, on average, doctors interrupt patients within twenty-three seconds from the time a patient begins explaining his or her symptoms. The same study found that during 25 percent of visits, doctors don’t even ask patients what is bothering them. Another study showed that three out of four doctors failed to give clear instructions to patients on how to take their medicines. And yet another study demonstrated that when asked to state their medication instructions, half of patients couldn’t do it.
None of this data suggests that patients or providers are having positive experiences with healthcare. It’s clear that “care” is the missing element in healthcare, and we need to do something to shake things up and bring the care back.
The insights of positive psychology
If care is currently missing, positive psychology offers some insight as to how we can bring it back. In 1998, Dr. Martin Seligman, incoming president of the American Psychological Association (APA), challenged the field of psychology to broaden its focus to study and implement interventions that went beyond human problems and pathology to include the study of human strengths and well-being—basically, what’s going right. He thus initiated positive psychology, which is “a science of positive subjective experience, positive individual traits, and positive institutions.”
Positive psychology takes a “strengths-based” approach to studying the specific ways people can build on their talents, skills, and values to generate greater happiness, success, and fulfillment. It is ripe with implications across a broad spectrum of professions, among them healthcare.
Positive psychology literature has grown rapidly in significance since Seligman’s challenge in 1998, generating over 18,000 scientific papers (2,300 were published in 2011 alone) and representing over 4 percent of PsycINFO, which is the largest source of psychological literature. This huge repository of data-based knowledge offers healthcare providers an equally huge opportunity to learn what kinds of psychological factors can contribute to our patients’ improved mental, emotional, and physical well-being.
Positive psychology shows that behaviors like listening, empathy, and positivity facilitate better patient experiences that influence, renew, or enhance each healthcare practitioner’s sense of purpose, and provide a far different healthcare experience than the one today’s patients have unfortunately come to expect.
In other words, positive psychology proves that “soft skills” aren’t just good for building a nicer work environment. They also dramatically enhance workplace innovation and promote better health outcomes for patients.
The opportunities of positive healthcare
The struggles that both healthcare providers and patients experience make healthcare an excellent industry for applying, developing, and refining evidence-based interventions and techniques from positive psychology. The alignment of these two disciplines presents a unique opportunity with the potential to substantially and positively impact patient outcomes.
Healthcare practitioners can rehumanize healthcare by correlating their clinical outcomes with research on empathy, compassion, and other portable concepts within the field of positive psychology. These insights can help them more effectively collaborate with patients, set realistic goals, and make joint decisions, which undoubtedly influence results. Engaging in a collaborative model of shared decision-making allows patients to feel in control of the healing process and their therapeutic decisions. A patient’s autonomy increases ownership of the joint plan, enhances the therapeutic alliance between patient and doctor, and makes adherence to and engagement with the treatment more likely.
And by turning the insights of positive psychology onto their own lives and practices, providers can also find renewed purpose, meaning, and calling in their careers, which also reduces provider burnout and attrition.
Look beyond the physical and find meaning
In November 2013, when I received the Robert G. Dicus Award, the most highly regarded award in private practice physical therapy by our professional association, I shared the implications of positive psychology with several thousand of my colleagues. During my acceptance speech, I asked them to look beyond a patient’s physical recovery and consider the importance of interventions that enhance overall well-being.
In my experience, healthcare providers of all types are called to purposeful and meaningful work. They didn’t take up their career because they love reading charts and filling out forms. If we want to reinvigorate professionals’ sense of purpose, we have to reintegrate “care” into healthcare and elevate the experiences of patients and healthcare practitioners alike.
There is a better, more effective way to heal that doesn’t have anything to do with clinical trials, treatment plans, or paperwork. It has everything to do with humanity and heart.
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