Caring, Compassion and Humility: A Proposed New Model for Medicine Closer to the Heart


Presented By Ken Hilsbos, M.D.

Family Doctor at the Fairmont Clinic Rural Community Health Center in West Virginia (founded by Coal Miners in 1958)

Modern American Medicine is based on the Biomedical Model. The Biomedical Model emphasizes science and technological innovation. Feelings and relationships get shoved aside. More and more, our Medicine is bumping up against the limitations of technology. If your heart is sick from years of eating feedlot beef, we bust your blood clots, balloon your arteries, bypass your blockage, and even replace your heart. But if you're heartsick because you're a single mother who can't make ends meet, and the kids always do without, and the guys always just take what they can get--then don't waste your time seeing a typical doctor.


We need a different mental construct. We need to improve other aspects of Medicine, not build a better PET scanner. Instead of yet another machine, yet another drug, what we need to do is to use what we know about human misery and how to alleviate it.


Let's shift the focus from technology to values. Three key values are caring, compassion, and humility.


The patient wants to know how much you care before they care how much you know. Let's adopt caring as our central value, our central organizing principal. Rather than just striving to "practice good medicine" let's strive to "take good care of the patient." That, of course, is just a start toward "caring." The caring relationship requires nurturing the patient and caring about what happens to them. Let's not crusade against death. Rather, let's devote ourselves to caring for our fellow travelers--with love, with wisdom and with compassion.


Compassion means "suffering with." The best doctors feel as their own the suffering of their patients and the patients' loved ones. But in American Medicine, on the whole, we need a lot more compassion.


Compassion means empathy and kindness. Sometimes the patient needs these much more than they need another test. In fact, if the patient trusts you, they'll often volunteer the key information needed to solve the case--data that thousands of dollars worth of tests could not provide.


Now we come to the really big deficit. Humility. We doctors have to have strong egos, strong self-confidence. But to truly understand a person requires a feeling of equality. This person here asking for my help might have a third grade education, or Down's syndrome, or an annoying lack of access to soap and water--but they don't really understand death, or the joys of birth, or the other great mysteries, any less than I do. Together we can discover our humanity.


The great Brazilian educator, Paulo Freire, brought the ideas of Liberation Theology into the field of education. He has taught us that big money interests transform everything into objects of their domination. Not only commodities, but even the Earth, time and other people, become objects at the disposal of the dominant class. Modern Medicine reduces the patient to an object. The doctor moves the patients, the objects, through the assembly line--I mean the health care system--with maximum efficiency, the efficiency of how many widgets per day. Is it 20 patient visits per day? 30? 50? Sound bite medicine.


At least some of us heard a call to be doctors. I did not hear any call to see at least 20 patients a day, nor did I hear a call to make a lot of money. I was called to help people, to serve, to relieve suffering.


Only by dialogue with our patients--as equals--can we doctors and out patients become fully human--and healthy.