Issue link: https://viewer.e-digitaledition.com/i/1043624
Research such as a 2017 study in Patient P reference and Adherence ha s found a si g n i f ic a nt rel at ion s h ip b et we en prov ider EI a nd patient satisfaction. In t u r n, patient satisfa ction a f fect s Medica re reimbursement. BARRIERS TO CONNECTING W h i le Scot t R esn ick , M D, ow ner of Chatta nooga Functiona l Medicine in Chatta nooga, Tennessee, believes that to some degree EI can be taught, he sees that as a Catch-22. Physicians who lack those tra its of ten do not rea lize they need to develop them, Dr. Resnick says. Even for clinicia ns w ith strong EI, str uct ura l or reg u lator y issues pose obstacles to connecting with patients as they would like a nd ca n foster burnout. "Physicians who truly operate within a state of EI a lways provide a high level of care," Dr. Resnick says. "The problem is ... it is ha rd to ma inta in this within current work loads a nd bureaucracy." His solution ha s been to operate a practice that does not accept insurance a nd thus enables him to offer patients a g reater level of engagement. " Patients come to me because they wa nt to be listened to i n a ca lm a nd ca ring environment," Dr. Resnick says. THE ROLE OF SELF-CARE Robust EI not only improves care, but it also enhances providers' quality of life, according to Brian Levine, MD, Program D i r e c t or for E mer genc y Me d ic i ne Residency at Christiana Care Hea lth System in Newark, Delaware. He points to his work in emergency medicine. "My fi rst fi ve to 10 years of practice, I used to drive home from a shift and think of every patient I cared for, and it started to burn me out," Dr. Levine says. "I was worried about what I sent home — did I miss something. It really beats you up." Today, he emphasizes maintaining clear work/life boundaries as much as possible — specif ica lly, not bring ing outside stresses to the hospital. It is also important not to take negative interac- tions with patients persona lly and to develop healthy ways of coping with loss. " W hen you see someone die — in a busy, high-acuity a rea like ours, some- times one or t wo deaths a shif t — you ca n't let that pa ra lyze you or your other patients," Dr. Lev ine says. " Because you a re dea l i n g w it h l i fe a nd deat h, you have to sepa rate from that. In that high-stress environment, it ca n rea lly a lter your abi lit y to be appropriately engaged emotiona lly." " You should really remember why you went into medicine. Every time I see a patient, I always try to remember that they are someone's son or daughter or mother or father. If you treat them as a loved one, you can never go wrong. It keeps you grounded." — BRIAN LEVINE, MD, PROGRAM DIRECTOR FOR EMERGENCY MEDICINE RESIDENCY, CHRISTIANA CARE HEALTH SYSTEM, NEWARK, DELAWARE Recha rging through mea ns such as exercise, meditation or spending time with loved ones helps. "Early in my career, I thought I'd just work ha rder, but it puts you f ur ther into a diff icult situation," Dr. Levine says. "Brea king away and doing things that a re fa mily-oriented, about you — sepa rating yourself through va rious techniques — is impor ta nt." NATURE VS. NURTURE W hile some hea lthca re workers have natura lly high EI, it is atta inable for others as well. A 2015 literature review in the International Journal of Medical Education found that ski l ls such a s perceiv ing a nd ma na g ing emotions may improve through tra ining. Understa nding that something a s simple as sitting with patients as you ta lk versus standing and ta lking down to them ca n enha nce their perception of the ca re delivered. " No mat ter how sma r t you a re or how good you a re, it doesn't rea l ly mat ter t hat much, to be completely honest," Dr. Levine says. " There's a n old say ing: 'No one ca res how sma r t you a re. T hey on ly ca re how much you ca re.'" n M D N E W S . C O M /// M D N E W S C E N T R A l N E W Y O R K ■ 2 018 1 3