Shame and Pride; Pity and Sympathy: No Match for Wholehearted Empathy

I'm forever grateful to David Aspy, EdD, now a mentor from heaven, who taught me empathy and more.  He had directed the National Consortium for Humanizing Education in the 1970's and wrote Kids Don't Learn from People They Don't Like with Flora N. Roebuck, EdD in 1977, among other works.  As a resident physician, I was looking for teaching strategies to help resident physicians improve their teaching skills as head of a workgroup for the AMA Resident Physician Section in 1977-78.

Al Vastyan, PhD in the Humanities Department at Penn State, Hershey an important part of the MS Hershey, knew of the project.  He called me one day with sudden enthusiasm about the project when he read an article by Dr. Aspy.  I read the article and called Eastern Kentucky University where Dr Aspy had relocated his work.  We talked a good while.  He sent me a packet of books including the one above.  I was hooked.  And excited about others of his writings such as Toward a Technology for Humanizing Education.

He invited me to Richmond, KY to learn more.  Dave spent two days teaching me about empathy, congruence and genuineness as applied to audio and video-tape analysis of teacher-learner situations.  He showed me the work of Robert Carkhuff, PhD about teaching and helping.  The Art of Helping, The Skills of Teaching:  Interpersonal Skills and the Carkhuff Interpersonal Skills Scale were included.

Two key pieces of the training were included in the Cognitive Functioning Categories Training Module by Dr.'s Aspy and Roebuck.  The Flander's Interaction Analysis rounded out the tape rating checklists and skill training scenarios.
Listen to my Dr Synonymous Broadcast to hear more:
Dr Jonas on BlogTalk Radio as Dr Synonymous

Thanks to Dave Aspy for his mentorship and message.
 
The transformation of medical practice has taken many physicians away from personalized patient engagement.  Accurate empathy has been shown to facilitate learning by students and patients.  Is it time to re-emphasize accurate empathy and even grade some patient-physician interactions for how we teach and learn from each other?  Has "Meaningless Use" and Bonus Based Medicine taken physicians away from empathy?  Can medical practice recover from our mis-alignment with societal and patient needs?

Should we have a National Consortium for Humanizing Medicine?  Health Care?

"More Than Words, More than Us"

I was struck by the words of the title for this post while listening in church today to Rev. Jay Rundell, the guest minister.  The sermon title, "Gratitude in Trying Times", was about the struggles of the Apostle Paul, in Philippians 4:4-13.  The sermon itself was about all of us and our struggles.  "Sometimes we need to listen," he said.

6  Be careful for nothing; but in every thing by prayer and supplication with thanksgiving let your requests be made known unto God.

7  And the peace of God, which passeth all understanding, shall keep your hearts and minds through Christ Jesus.

9  Those things, which ye have both learned, and received, and heard, and seen in me, do: and the God of peace shall be with you.

13  I can do all things through Christ which strengtheneth me.  14  Notwithstanding ye have well done, that ye did communicate with my affliction.

A lot of sermons have been preached using this section of Philippians.  A key point or two of the presenter today was the  "Praying with Gratitude" in verse 6, the "Doing" in verse 9, and the "Sharing" of the struggle with others and their "Connection" to the struggle in verse 14.

Part of the message was to "Pray, Do, Share and Connect".  Validate each other with action and shared struggles.  Be human.  Serve God.  Don't expect life to be all rosy.

Do = "More than words" ("More than prayer")
Share = "More than us" ("More than me")

As we dialog with God through prayer and act on our discernments, we should dialog/ share with others about our struggles and mutually connect to allow reconciliation of our struggles, losses and griefs.

I thought, there must be a hymn that uses those words in the title.  I'll look for it.  If it were already written, it might be something like this (or would it?):

I thought it was over, I thought life was done
So empty I shook with despair
I asked God to help in the name of His Son
But I couldn't tell He was there

I shared my dilemma with some of my friends
They listened and prayed for God's Love
To soften my heart and then never to end
Below can be just as above

I prayed and I listened and listened some more
The peace in the silence shone through
My heart beat was thankful for all He had done
God showed me just what I could do


Chorus:     The Heartfelt Joy of understanding
                   Deepest Peace that we can trust
                   God will touch us as we gather
                   More than words, More than us


(The last line of the last verse could say I or could say God or He, according to how it's perceived.)

(Rev. Rundell's wife is a Family Physician in medical education at my alma mater-The Ohio State University)

Direct Primary Care: Ohio

Ohio Academy of Family Physicians discussing DPC.  Some thoughts.

Click Here:  Direct Primary Care Defined

Click Here: DPC Coalition site

Prepare to aggregate information about DPC for members.

Collaborate with meetings about DPC.  Speak at meetings about DPC w/ OAFP perspective

Influence FMIG's, Departments of FM and residencies about DPC

Buffer movements that add unreasonable restrictions to DPC

Short may be better.  Watch out for restrictive language in def and/or legislation.

Less is better legislatively.

Family Medicine makes for great DPC physicians.

Legislation- escape from insurance.  Specifically exclude DPC from oversight  by insurance commish.

Avoid written agreements w/ patients unless you want it for all pts of all FamilyPhysicians.

Protect each physician's scope of practice.

Ask for same considerations of med profession as legal profession would get for practice.

Avoid phony quality initiatives.

Have pride in Family Medicine.  We're good.  We're well trained.

Don't let poor self esteem cause restrictions of DPC Docs legislatively.  We're good.

Search Dr Synonymous about DPC = >50 posts with lots of information.

Meaningful Use for Symphonies

I went to the symphony tonight.  I enjoy some classical music from time to time.  I remember playing the Barber of Seville record from the Reader's Digest Classic Collection in 1963 before each high school football game to get focused and fired up (it's true).  Chopin is another favorite of mine.

After the usual warm-ups, the conductor focused the symphony by raising the baton and leading them.  They proceeded to play eight perfect scales.  The conductor bowed.  We applauded.  He enjoined the symphony to stand and bow.  We applauded.

They sat down and played another scale perfectly.  And bowed.  We applauded.  The conductor bowed again and walked off the stage.

The master of ceremonies entered, "That's our concert for tonight, Ladies and Gentlemen.  I hope you enjoyed our first concert to honor the medical profession and the physicians in our community.  We followed their lead and demonstrated Meaningful Use of our instruments.  We hope you enjoyed it. We appreciate the attendance of our government regulators tonight, too.  They will judge our Meaningful Use quality and let us know within three months when we get to do another performance,  in a Meaningful way.  Goodnight"

BTR Show: Hybrid DPC Can be Done- It Ain't Easy

My Weekly Dr. Synonymous Show on BlogTalk Radio: Reviews primary care payment evolution and options from cash pay to insurance to direct pay monthly and others.  IT makes it possible to relate in the current complex system (s) in ways that are still sensitive to patient and physician needs.  Here is the link:

Click Here

Hybrid DPC- Can Be Done, BUT Harder than New Pure DPC

Dr Jonas, your host on the Dr Synonymous Show will discuss some aspects of Hybrid Direct Primary Care that are challenging hurdles for those with an existing practice who want to continue with their current patients while adding Direct Primary Care.  It doesn't have to be either/or for everyone.

Generally DPC is for private practice physicians.  That's who I'm talking to in this show.

Next is a commentary about Osteoporosis in Men as presented in the Journal of Family Practice in September.

A blog and tweet review follows.

Other items on this show will include a review of two medicare ads for patients.