MDNews - Minnesota

"The same way we keep up our clinical skills and make sure we know what we're doing medically, we should also be aware of what's happening emotionally. [The emotional component] can harm patients, but it can also benefi t them." — Danielle Ofri, MD, PhD, Associate Professor of Medicine at New York University School of Medicine, physician at Bellevue Hospital and Editor-in-Chief of the Bellevue Literary Review Michael Anderson, Vice President of Human Resources within the Physician Services Division of the University of Pittsburgh Medical Center, noted that poor EI can lead to low patient satisfac- tion scores and affect Hospital Consumer Assessment of Healthcare Providers and Systems survey results and reimburse- ment. Additionally, Anderson noted, poor reviews and ratings can harm a hospital's reputation — a crucial factor when potential patients have abundant choices of facilities where they may receive care. Some healthcare facilities are respond- ing to these challenges by placing added emphasis on EI when making hires, and medical schools are already incorporating EI into their curriculums and student selection processes. Cultivating EI T he Un iversit y of Sout h Flor id a Morsani College of Medicine partnered with Lehigh Valley Health Network in Pennsylvania to introduce the Scholarly Excellence, Leadership Experiences and Collaborative Training (SELECT) program in 2011. SELECT includes a curriculum aimed at developing healthcare leaders by equip- ping them with EI competency during a rigorous four-year program that "inter- digitates" with their traditional medical school coursework, explains Robert G. Brooks, MD, MBA, MPH, Professor of Internal Medicine/Infectious Diseases at USF College of Medicine and Professor of Health Policy and Management at USF College of Public Health. "The three areas … that form the pillars of the curriculum are health leadership, health systems and policy … and value-based patient care," he says. "Each year, students in the SELECT program are given courses that include both didactic learning, and experiences and refl ection that relate to those three main core areas." The program is also at the forefront of medical schools implementing EI into their selection processes. After MCAT and GRE scores eliminate the first round of applicants, those who remain go through a unique second- round evaluative process developed by SELECT leaders. Behavioral event interviews (BEIs) illu- minate potential students' experiential prowess. Two faculty members trained in BEI techniques pose scenarios to which candidates react. Without knowledge of interviewees' MCAT scores or past aca- demic performance, faculty interviewers assess how nimbly candidates react to the scenarios and evaluate the candidates' abilities to adapt to the situation. Using EI As students refi ne their EI in medical school, current providers are tasked with demonstrating emotional adroitness in real-life interactions. As complicated as a diagnosis can be to make, delivering bad news can be equally diffi cult, says Da nielle Ofri, MD, PhD, A ssociate Professor of Medicine at New York University School of Medicine, physician at Bellevue Hospital and Editor-in-Chief of the Bellevue Literary Review. "We use medical data and facts … to help patients — these are all inert facts that could be delivered by a computer," Dr. Ofri says. "But when we, as physi- cians, nurses or other medical personnel, interact with patients, we filter the data through our human core. That changes how these inert facts apply to our patients." In a November 2013 post on The New York Times' Well Blog, Dr. Ofri — who also authored What Doctors Feel: How Emotions Affect the Practice of Medicine — explored the nuances of EI in the exam room. Often, experience is the best teacher. Because long-term patients are more fa milia r, their physicia ns a re more likely to detect subtle emotional cues. Dr. Ofri notes that delivering bad news is one area in which this is of utmost importance. Some patients want the bad news unfi ltered, but some don't want to be told by a physician at all — they would prefer that a loved one relay the diagnosis. "We can harm patients if we don't pick up on their cues," Dr. Ofri explains. "We have to have one radar up for 'What's the emotional situation?' — and it may not be perfect — but we have to at least be aware that many patients will give off clues to how receptive or unreceptive they are for sharing or how explicitly they want news [delivered]." Few would dispute that being sensitive to patients' emotions while also keeping t hem f ully informed about pa inf ul realities is a diffi cult balance. But EI's importance in effectively pursuing that goal is becoming clearer to providers and patients alike. "Prescribing a pill is only one part of [medical care]," Dr. Ofri notes. "There's so much more. Patients can be cured, but not healed. They know the difference between getting the right medicine and being taken care of." ■ M D N E W S . CO M ■ MD NEWS Minnesota | 1 1

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