ViewpointApril 3, 2024Medicine—Both a Science (Care) and an Art (CARE)
JAMA. Published online April 3, 2024. doi:10.1001/jama.2024.2508In the current era, health care is increasingly characterized by the integration of big data, predictive analytics, medical devices, and artificial intelligence. These technological advancements have undoubtedly transformed the landscape of medical care, offering unprecedented precision and efficiency in diagnosis and treatment.
Yet, amidst this surge of scientific innovation, the timeless art of medicine (compassion and caring) remains a foundational aspect of patient-centered health care.1 Despite the advances in technology, the qualities of compassion, assistance, active listening, respect, and empathy continue to be vital.2 These qualities not only contribute to better patient outcomes and increased satisfaction, but also play a crucial role in improving overall well-being.3
The acronym CARE (compassion, assistance, respect, and empathy) encapsulates these enduring values. These are not just words, but they are principles that guide the care of patients in a genuinely caring way. In a world increasingly driven by data and algorithms, these qualities foster a trusting and supportive relationship between health care professionals and patients, thereby enhancing the healing process and enriching the overall health care experience.
As described in their book,1 Trzeciak and Mazzarelli make it clear that compassion in health care transcends an emotional response; this is further nuanced by contemporary research. Empathy is the capacity to share and resonate with both the positive and negative feelings of others, which can lay the foundation for deep interpersonal connections. Compassion manifests as a feeling for others expressed through warmth, concern, and care, and is driven by a strong desire to enhance another individual's well-being.
Remarkably, compassion can be cultivated through training to build new skills with meditation and practice, thereby enhancing innate inclinations and adaptability to situational contexts. Trzeciak and Mazzarelli1 highlight that a genuine desire to assist is crucial, enabling the provision of care with the respect and dignity every patient deserves. This approach nurtures an empathetic understanding of a patient's situation. Consequently, CARE embodies both feelings and tangible actions.
As medicine and medical care have become more successful, and as science and technology improve diagnostic tools, therapeutics, and minimally invasive procedures, the personal interaction with patients and the belief that clinicians are compassionate has declined.3,4 Although robotics, artificial intelligence, electronic health records, telemedicine, and changing therapeutics are all important and have helped to improve the science of medicine, physicians can never forget that the art of medicine is just as important in patient healing.
Not unlike an artist who transforms beautiful colors only after the paint is skillfully and properly applied to the paint easel, this, too, must happen with the medical knowledge and skills physicians acquire. It is the responsibility of physicians to apply medical knowledge in their care of patients and provide individualized and unique medical CARE as its core. Health care must be integrated as both an art and a science. The "compassionomics" hypothesis of Trzeciak and Mazzarelli1 is: "There is science in the art of medicine."
All the scientific knowledge and skills acquired are rote unless applied to each patient with the art of care and compassion based on each patient's needs. "The compassion crisis will turn the profession of healthcare providers from a calling into a job."1 Compassion and caring are also greatly enhanced by one's spirituality. Studies have suggested that spirituality can have positive effects on patients' health care experiences.5,6 Research on spirituality6 indicates potential benefits such as improved coping mechanisms, reduced anxiety, and enhanced overall well-being.
Specific studies may focus on areas like mindfulness, prayer, or religious practices as components of spiritual care in health care settings. However, it is important to note that individual responses to spirituality can vary, and clinicians should approach this aspect of care with sensitivity and respect for diverse beliefs. Exploring needs and using spiritual aspects when caring for patients leads to a more empathetic and compassionate approach to the problem at hand no matter how large or small and no matter how routine or dire it may seem. It is about CARE.
As a profession, and as individual physicians, we cannot let computers and artificial intelligence purely dictate how we interact and care for our patients. Physicians need to be both scientists and artists applying the science with the artistic skills of CARE. This is our role in a world filled with facts without good interpretation, social media filled with misinformation, and the ability to access data with a simple click.
In an era when technology continuously redefines the boundaries of medical science, we stand at a pivotal crossroads. The question we face is not just about how advanced the tools and treatments can become, but about how deeply we can care for each individual who seeks healing. As we venture forward, each of us in the health care profession must ask ourselves: How will we blend the precision of science with the warmth of compassion in our daily practice? How can we ensure that our patients feel heard, respected, and genuinely cared for despite the inevitable march of medical innovation?
The challenge before us is to not only embrace the rapid advancements in medical science, but also to elevate the art of compassionate care. We must believe that caring and compassion make a difference. Compassionate care makes us all better healers. Caring is more than just medical treatment. It involves compassion, respect, kindness, and building trusting relationships. Compassionate care can improve patient outcomes, satisfaction, and loyalty as well as reduce stress and burnout for health care professionals.
Interventions that improve the patient-physician relationship are associated with better outcomes for patients and were recently assessed in a review by Malenfant et al.3 Compassion and caring must be taught and practiced alongside all learning from the very start of medical school through to the completion of the most specialized residencies to ensure the proper balance of CARE and caring (the science and the art).
As physicians have been moved away from direct patient contact because of technological advances, it is imperative that we understand how to use the best that science and technology now offer. We must do so in ways that reconnect us with patients personally and the CARE that is at the core of those relationships. "No one cares how much you know, until they know how much you care" (speaker unknown but often attributed to Theodore Roosevelt).
Back to topArticle InformationCorresponding Author: Theodore J. Strange, MD, Northwell Health System, 2000 Marcus Ave, New Hyde Park, NY 11042 (tstrange@northwell.edu).
Published Online: April 3, 2024. doi:10.1001/jama.2024.2508
Conflict of Interest Disclosures: None reported.
References1.Trzeciak S, Mazzarelli A. Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference. Huron Consulting Services LLC; 2019.2.American Medical Association. AMA principles of medical ethics. Accessed January 18, 2024. https://code-medical-ethics.ama-assn.org/principles3.Malenfant S, Jaggi P, Hayden KA, Sinclair S. Compassion in healthcare: an updated scoping review of the literature. BMC Palliat Care. 2022;21(1):80. doi:10.1186/s12904-022-00942-3PubMedGoogle ScholarCrossref4.Hryciw BN, Fortin Z, Ghossein J, Kyeremanteng K. Doctor-patient interactions in the age of AI: navigating innovation and expertise. Front Med (Lausanne). 2023;10:1241508. doi:10.3389/fmed.2023.1241508Google ScholarCrossref5.Balboni TA, VanderWeele TJ, Doan-Soares SD, et al. Spirituality in serious illness and health. JAMA. 2022;328(2):184-197. doi:10.1001/jama.2022.11086
ArticlePubMedGoogle ScholarCrossref6.VanderWeele TJ, Balboni TA, Koh HK. Health and spirituality. JAMA. 2017;318(6):519-520. doi:10.1001/jama.2017.8136
ArticlePubMedGoogle ScholarCrossref
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