You can’t spell “healthcare” without “care”, but that doesn’t mean compassion and care are always present in healthcare environments. Compassion is central to teamwork, effective care delivery, good patient outcomes and employee satisfaction1. So how do we harvest and protect this important ingredient?
Dr Joshua D. Hartzell’s book offers a “prescription” divided into 23 sub-prescriptions, one for each chapter, to help anyone working in healthcare to reform or enhance their way of leading. Each prescription is addressed to a certain “ailment” that impairs compassion in healthcare such as the lack of care in healthcare leadership, and “goals” such as “care enough” to: delegate, give feedback, and others. These “ailments” and “goals” are comprehensively described through summaries of literature reviews and interviews, and are given proposed solutions, supported by Dr Hartzell’s professional experience, the experience of those interviewed, as well as his literature; both published and grey findings. When it comes to the problems that affect the interprofessional care, Dr Hartzell investigates the root cause across the whole multi-disciplinary team, from what can affect team members, such as burnout and lack of progression, to oneself. The prescriptions provided offer solutions, as well as suggestions for further reading.
The font size, layout, and chapter divisions make it an easy read, even if read amongst a busy schedule. The language used is easy to understand, with a friendly “mentor to mentee” or “peer to peer” approach, largely jargon free while also navigating the literature overview, with a gentle approach to challenging topics. It felt like being taught by a friend or a very approachable senior, which increased the feeling of achievability of each proposed solution. The author makes each issue relatable, which helps with understanding perspectives you’ve never experienced yourself before. The language used is very approachable, even for someone like me, whose first language isn’t English, and at no point did I not feel at ease or feel reminded of my linguistic positionality.
One of the features I appreciated the most was the practicality of this book. As someone that is neurodivergent, and often with an overfilled schedule, I appreciated the fact that the sub-prescriptions covered the chapter’s main practical advice, as well as each chapter having golden nuggets of advice from both the author himself as well as those interviewed. The multi-disciplinary approach of the book is deeply valuable – although written by a now retired doctor, those interviewed include nurses, a psychologist, a physiotherapist, a clinician that is also a scientist, a coach, and more. What may have been missing from this list of interviewees was someone that was perhaps not at the top of their career.. Even though the book refers to residents in many places, it may have been valuable, as a resident myself with a rich portfolio in leadership, QI, and education, to see someone “like me” represented, to enhance the idea that improvement can (and arguably should) be achieved at any stage.
My favourite chapter was “The business case for caring as a leader”, which offers enough information to convince anyone of the importance of compassion. It also provides useful points to make when convincing others about the importance of investing in compassionate healthcare – something I find we still sadly have to do.
While the book is focused on US healthcare , the majority can be applied to any country, with the appropriate cultural adaptations. The book references a highly contemporary topic that we are very familiar with in the UK – industrial action over pay and working conditions, and the need for trade union intervention in order to ask for basic recognition over what a worker deserves. Here, the author notes that residents, as those that work the most hours and are paid poorly, yet are expected to always put patients first despite being at a breaking point themselves. As a trade unionist with a trade union role for some years, having led picket lines, it’s been heartwarming to see this core issue of healthcare acknowledged in a book about compassion..
So, to conclude – is this book worth it? Even as someone that has completed a leadership fellowship, with positive feedback on my compassionate approach, I can honestly say that there was still a lot that I learnt and am yet to learn from this book. So, whether you think you master compassion in healthcare (leadership) or not, I encourage you to give it a try and share it wider.
References
- de Zulueta P. How do we sustain compassionate healthcare? Compassionate leadership in the time of the COVID-19 pandemic. Clinics in Integrated Care. 2021 Oct;8:100071. doi: 10.1016/j.intcar.2021.100071. Epub 2021 Sep 9. PMCID: PMC8450772.
Book reviewer
Dr. Cristina Costache
Dr. Cristina Costache is a paediatric registrar, aspiring paediatric cardiologist, PhD student at the University of Manchester, and passionate trade unionist for the British Medical Association as currently elected national BMA Council member. She was born and did her undergraduate studies in Romania, but has resided in the UK for 9 years, and has actively been involved in medical education and leadership this whole time, despite acquiring a disability and being neurodivergent (for which she has become an advocate).
Declaration of interests
I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: Regardless of the organisations I am involved in, this review is written in a personal capacity.