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How is Vermont Doing - By Dr. Gene Lindsey

Improving Health Care Delivery: Empathy and Adaptive Change

In November, 2015 I attended a unique healthcare meeting in Stowe, Vermont. The Vermont Medical Society was meeting in a joint session with the Vermont Chapters of the American Academy of Pediatrics, the American College of Physicians, the American College of Surgeons and the Vermont Academy of Family Physicians as well as the Vermont Psychiatric Association. The agenda was as unique as the audience.

The Keynote address was delivered by Dr. Helen Riess from the MGH whose presentation was entitled “Professional Empathy Research: How Empathy Improves the Patient Experience, Improves Health Outcomes, and Reduces Costs”. She was terrific. Who knew empathy could be taught? Empathy can be measured and the impact of the absence of empathy can be measured down to the level of clinical outcomes and cost. The talk was complete with the neuroanatomy of empathy and a description of the external expressions of concern that patients can sense and that physicians who care about the outcomes of their patients can modify. Her research uses changes in electrical conductance in the skin to show either synchrony or discordance between patients and their physicians. Her final fact of importance, backed by data, was her demonstration that improved empathy reduces clinician burnout and “infuses meaning and joy back into work”.

I was there to get a better feel for the mind of clinical leadership at a moment of great transition in Vermont. The subject that was at the core of the conference was the future of care in Vermont. I think that someone had a stroke of genius when they decided to weave a program from threads of traditional clinical discussions with a chance to talk about concerns and provide new information about the evolving policy issues that will determine the future of practice in Vermont.

It seemed that the activities were one big exercise designed to help Vermont’s physician leaders to come together to discern “what to conserve from past practices, ...what to discard from past practices, and [consider] inventing new ways that build from the best of the past,” as Dr. Heifitz has said about the process of adaptive change.  To actively assist the objective, the important discussion on the first day was entitled “Taking the Lead: Physician Roles in Health Reform”. It was a review of innovative efforts in several statewide value streams that had created opportunities for a wide variety of physicians to get involved in projects that would begin to transform practice while bringing them together across geography and between institutions.