In a moving article in a recent BMJ, a young doctor talks from her own experience about what it is like being a patient with terminal cancer1. She says, “I have four key values as both a clinician and as a patient. These are proper effective communication, ‘little things’ such as holding someone’s hand or sitting down at their level really matter, ‘no decision about me without me,’ and ‘see me, not just my disease.’ These values make me who I am and I believe are vital to consider when providing true compassionate care.”
These are important values for all health-care professionals seeking to practise patient-centred care, and we need to take care to maintain them when the circumstances and systems in which we work may not encourage us to do so. Our managers and professional bodies are rightly concerned about us being competent, but often fail to recognise that compassion is part of true competence, and whilst time, effort and training resource is directed at maintaining competence, little of that may include the vital maintenance of compassion, without which we will inevitably be less competent. The author of the article goes on to say, “When I first became a doctor I was very concerned about correct diagnoses and treatments. If you’d asked me what the most important quality of a doctor was I would have said competence. When I became a patient I soon realised how important compassionate attributes in the people looking after me were and how much I valued those. I am yet to meet a compassionate doctor on this journey who wasn’t also competent. The gentle arm rub by the consultant on Saturday night when I was at my most frightened and vulnerable was maybe one of the most important aspects of care I received that weekend.”
What a striking phrase: I am yet to meet a compassionate doctor…who wasn’t also competent. But if we think about it, not really surprising, because compassion for our patients will inevitably mean we want to provide the best possible care for them, which requires competence in our discipline. How good to read of a consultant showing compassion by taking the time to offer a simple reassuring human touch to this frightened and vulnerable patient.
It is PRIME’s vision that all health-care professionals should practice and teach compassionate care. Often perhaps this is seen as something additional to and separate from professional competence, but this article reminds us that in truth the two are inextricably linked – you can’t be competent unless you are also compassionate. Does your understanding of competence in your discipline include the importance of showing compassion? Do you teach this to your students or residents?
Let us all seek to demonstrate our competence by the compassion we show to our patients and colleagues.
Dr Huw Morgan
Senior PRIME tutor