Compassion is the humane quality of understanding the suffering of others and wanting to do something about it. It isn’t only showing concern for a major loss like the death of a loved one, for example. You can also show compassion for the patient whose financial problems force them to choose a less than ideal treatment. Compassion is being able to put yourself in another person’s place. Feel what they feel.

It would be nice if compassion were a universal trait that needed no instruction, but not everyone seems innately capable of understanding the problems of others, especially when those problems represent an inconvenience or are not clearly expressed. Even if you run behind schedule and want the patient to decide upon a treatment plan, or you want them to stop asking the same questions over and over, you must remain compassionate. Some patients can’t express their feelings or needs and the practitioner must learn how to recognize, in a caring manner, what the patient requires.

Some practitioners have difficulty showing emotion, even when they feel it. There are others who start out empathetic then become burned out by constant exposure to sad events. It’s difficult for some practitioners to understand the possibility of losing compassion, the result of burnout, but it’s true. It is important to recognize the possibility, because stress and emotional detachment can cross over into relationships with family and friends. As a result, not only will your patients think you are detached, but so will your loved ones.

Whether or not you innately possess compassion, the day-to-day trials and tribulations of life can sometimes force you to become complacent and neglect the emotional needs of your patients. Fortunately, there are some simple rules that will allow you to fake it. After faking it long enough, it may actually become genuine—even if you have an inherent lack of compassion.

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You treat a disease, you win, you lose. You treat a person, I guarantee you, you'll win, no matter what the outcome.

We need to start treating the patient as well as the disease.

Hunter “Patch” Adams

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Loss is the driving force behind the need for compassion. In health care, there are four areas of loss that require you to express compassion: loss of money (financial concerns), failing procedures, loss of function, and loss of life. There are different ways to express compassion with each type of loss, but the common goal is to show you care.

LOSS OF MONEY

While fiscal matters shouldn’t be part of health-care delivery, they do affect every patient. As medical practitioners we don’t like to address fiscal issues, but their effect on the way doctors are perceived by patients cannot be ignored. It is difficult for a patient to respect the doctor they perceive as more concerned with money than their well-being. Fiscal policies impact how patients perceive your compassion when those policies determine the difference between obtaining proper care and being refused treatment.

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A disgruntled patient: “I just couldn’t go back to Dr. Smith. When I told him I couldn’t afford the treatment he suggested, he told me to call him when I could find a way to make it happen. He never offered any alternatives and I felt abandoned.”

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Many medical doctors participate in so many insurance plans that they and their patients have no interest in discussing fees. If all treatments are fully covered, then there is no need to discuss fees. However, don’t be surprised or disappointed when patients complain and refuse to pay your bill because they thought your services were covered, and they’re not.

If your service requires substantial uncovered fees or large co-payments, you should make sure the patients understand their responsibility. Some doctors find it difficult to discuss money. Many practice management gurus actually don’t want the doctors to discuss money with the patients. Remember, these are the same experts who show you how to make a lot of money by herding patients like cattle. They want you to limit your time to treatment planning and treatment, while they would have auxiliary staff present the financials.

You shouldn’t be expected to take the money, set up payment plans, and make the next appointment; however, discussing fees, rather than delegating this task to a staff member, helps you bond with your patient. It shows that you have compassion for financial concerns.

Patients receiving treatment not covered by insurance don’t like being herded into the financial arrangement office. It is very impersonal and will cause many to seek treatment from another practitioner. Those who are bullied into accepting treatment they can’t afford will often become noncompliant patients who never follow through, or they will end up in collection, resulting in you performing treatment for which you never get paid.

To avoid the discontent that results in patients leaving your practice and slandering you due to financial misunderstandings, you should discuss fees and make sure the patient is aware that they are responsible for any uncovered treatment. Fiscal responsibility shouldn’t be in the small print after ten pages of material your office staff asks them to read and sign. Be upfront about fees, insurance coverage, and expectations of getting paid for services rendered.

If you discuss fees compassionately, patients will see you are sensitive to their financial concerns as well as their medical problems.

After I quote a fee, I always mention that, “Root canal therapy is expensive, but it’s best to try to save your tooth if you can afford it.” This lets the patient know I understand potential financial concerns. It helps them discuss the issue without embarrassment.

If I quote a fee, and before I have a chance to mention how expensive it is, the patient makes a face that looks like they were just told they have a week to live, I modify my line slightly: “I know that’s an awful lot of money, and while it’s best to try to keep your tooth if you can afford it, there are other, less expensive alternatives.”

Showing concern for the high cost of services is an expression of compassion not usually thought about by health-care providers who often don’t understand that many patients cannot afford optimal care.

Even if you treat wealthy patients, never assume that a fee isn’t a potential burden unless you have known the patient for many years and can take that liberty. Fees should always be quoted, in a compassionate manner, even for patients who you expect to have full insurance coverage for a particular treatment. This shows patients you understand the expense involved and it puts a value on what they receive.  If it turns out that they didn’t have the coverage you and they expected, they will not be totally shocked at their financial responsibility.