The Role of Empathy In Improving Patient Care and Decreasing Medical Liability

Studies reveal that more than half of all practicing physicians demonstrate signs of burnout. Contemporary physicians face tremendous pressures due to a confluence of factors, including balancing heavy patient loads within constrained schedules, the increasing complexity of patient health problems, and increasingly burdensome COVID-related documentation requirements.

These circumstances—and more—challenge physician empathy, and even to some extent dampen it even further. Multiple research studies document a decline in empathy that appears to begin in the third year of medical school and persists during residency.  The pandemic has exacerbated this deterioration. In the past, empathy rebounded after the rigors of training were over, but today, empathy needs to be refreshed to help both patients and providers. Physicians who lose sight of the meaning, purpose, and rewards of their roles in patients’ lives suffer more from burnout than those who remain connected to their purpose.

The role of empathy training

In response to patients’ pleas for more empathic care and national media headlines calling for more compassion in medicine, which have been growing since about 2005, empathy training courses grounded in the neuroscience of emotions and emotional intelligence can be helpful. In fact, recent neuroscience research on the brain’s plasticity in up-regulating and down-regulating empathy provided evidence that empathy could be taught.

The research team in the Empathy and Relational Science program at Massachusetts General conducted a study of the effectiveness of the three, 60-minute empathy training courses in physicians. Researchers found statistically significant improvement in patient perception of physician empathy on a validated and reliable empathy rating scale called the “CARE measure.” Another study by the same team show that empathic physician behaviors resulted in higher ratings of both physician warmth and competence.

One of the most frequently asked questions about empathy training is, “Doesn’t this just add even more time to a busy doctor’s day?” Actually, it does not. Empathic care does not have to take more time. Courses on empathy training help health care professionals detect subtle emotional cues and nuances that indicate patient concerns so they can be addressed right away.

In addition, when physicians convey empathy, they put patients at ease, increasing trust in the provider-patient relationship. This creates a dynamic that ensures that small problems are addressed before they become bigger problems. Multiple studies have demonstrated that better medical outcomes are also correlated with strong empathy and relational skills.

Empathy training offers many benefits 

Courses based on empathy research and principles provide training for each of the following predictors of risk of increasing medical professional liability claims:

  1. Physicians’ uncaring attitudes, attitudes of superiority, or callousness
  2.  Communication failures including not listening, interrupting, or not being clear about availability or backup coverage
  3. Disparagement of previous care
  4. Failure to learn and manage patient expectations

Physicians can learn how to perceive patient emotions, manage difficult interactions, and communicate bad news. Empathy education teaches how to respond with empathy and compassion even in challenging situations, including informed consent conversations and inter-team conflicts.

In addition to greater patient satisfaction, doctors also discover the personal satisfaction that connecting with their patients in a more meaningful way provides.  “After empathy training, I feel that I like my work again, and instead of resenting all the demands, I’m remembering why I chose this profession in the first place,” a physician reported.

Interviews and research around empathy-based practices reveal that greater empathy not only improves patient satisfaction, but also helps to reduce physician burnout and improve physician job satisfaction. By using empathy-based skills, physicians, nurses, and other providers become more attuned to the needs of patients and their families. With this greater perception and shifts in attitudes, communication between providers and patients improves.

More empathic conversations will enable patients to trust their care to physicians who are confident in their skills without demeaning prior care they may have received. Patients will appreciate physicians who explain things clearly, ask about and understand their expectations, and form alignment about what is desired, likely, and possible.

Empathy-based training brings rewards

Through empathy-based training, physicians and other health care providers learn the skills to have honest informed consent discussions without causing undo fear, while also preparing patients for all possible outcomes. Empathic skills make for better physicians, better communications, and better conversations for all outcomes.

With a strong alliance, a reduction in medical professional liability claims is the result of increased trust, better understanding and expectations of all possible outcomes, and knowledge that physicians deeply care about their patients, because, when it comes to health care, empathy matters.

Helen Riess is a psychiatrist and author of The Empathy Effect: Seven Neuroscience-Based Keys for Transforming the Way We Live, Love, Work, and Connect Across Differences. This article originally appeared in Inside Medical Liability.

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Ethereum Co-Founder Anthony Di Iorio Says Safety Concern Has Him Quitting Crypto

Anthony Di Iorio, a co-founder of the Ethereum network, says he’s done with the cryptocurrency world, partially because of personal safety concerns.

Di Iorio, 48, has had a security team since 2017, with someone traveling with or meeting him wherever he goes. In coming weeks, he plans to sell Decentral Inc., and refocus on philanthropy and other ventures not related to crypto. The Canadian expects to sever ties in time with other startups he is involved with, and doesn’t plan on funding any more blockchain projects.

“It’s got a risk profile that I am not too enthused about,” said Di Iorio, who declined to disclose his cryptocurrency holdings or net worth. “I don’t feel necessarily safe in this space. If I was focused on larger problems, I think I’d be safer.”

Back in 2013, Di Iorio co-founded Ethereum, which has become the home of many of the hottest crypto projects, particularly in decentralized finance — which lets people borrow, lend and trade with each other without intermediaries like banks. Ether, the native token of the network, has a market value of about $225 billion.

He made a splash in 2018 when buying the largest and one of the most expensive condos in Canada, paying for it partly with digital money. Di Iorio purchased the three-story penthouse for C$28 million ($22 million) at the St. Regis Residences Toronto, the former Trump International Hotel & Tower in the downtown business district.

In recent years, Di Iorio jumped into venture-capital investing and startup advising. He was also for a time chief digital officer of the Toronto Stock Exchange. In February 2018, Forbes estimated his net worth was as high as $1 billion. Ether’s price has more than doubled since then.

Decentral is a Toronto-based innovation hub and software development company focused on decentralized technologies, and the maker of Jaxx, a digital asset wallet that garnered about 1 million customers this year.

Di Iorio said he has talked with a couple of potential investors, and believes the startup will be valued at “hundreds of millions.” He expects to sell the company for fiat, or equity in another company — not crypto.

“I want to diversify to not being a crypto guy, but being a guy tackling complex problems,” Di Iorio said. He is involved in Project Arrow, run by a high-school friend that’s building a zero-emission vehicle. He is also consulting a senator from Paraguay.

“I will incorporate crypto when needed, but a lot of times, it’s not,” he said. “It’s really a small percentage of what the world needs.”

Source: Ethereum Co-Founder Anthony Di Iorio Says Safety Concern Has Him Quitting Crypto – Bloomberg

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Critics:

Anthony Di Iorio is a Canadian entrepreneur primarily known as a co-founder of Ethereum and an early investor in Bitcoin. Di Iorio is the founder and CEO of the blockchain company Decentral, and the associated Jaxx wallet. He also served as the first chief digital officer of the Toronto Stock Exchange. In February 2018, Forbes estimated his net worth at $750 million–$1 billion.

Di Iorio grew up with two older siblings in north Toronto, Ontario. He graduated with a degree in marketing from Ryerson University. Di Iorio began developing websites during the early 1990s, and eventually entered the rental housing market as an investor and landlord in Toronto, Ontario. In 2012 he sold his rental properties in order to invest in Bitcoin, and began to organize companies in the field of cryptocurrency.

He first learned about bitcoin from a podcast called Free Talk Live in 2012. According to The Globe and Mail, he “had an anti-authoritarian streak” and  questioned “the fundamentals of mainstream economics.” Di Iorio bought his first bitcoin the same day for $9.73. He created the Toronto Bitcoin Meetup Group which held its first meeting at a pub in the same year.

It was at this first meeting where he met Vitalik Buterin who went on to be the founder of Bitcoin Magazine and one of the original creators of Ethereum. As the Meetups grew from about eight attendees to hundreds, Di Iorio formed the Bitcoin Alliance of Canada.

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UAE Suspends Issuance of All Entry Visas From March 17 

Abu Dhabi: The UAE on Saturday temporarily suspended the issuance of all entry visas except for those holders of diplomatic passports. This will be effective as of March 17.

The decision does not apply to persons who have already got visas before the effective date.

In a statement issued today, the Federal Authority For Identity and Citizenship said the move was taken as a precautionary measure being initiated by the country to contain the spread of coronavirus and is in response to the World Health Organisation declaring the novel coronavirus outbreak as a pandemic – which makes travel at this point dangerous.

The authority added that the decision will be effective until countries of departure activate a mechanism for medical screening of passengers as an additional measure.

It affirmed that the decision stems from the UAE’s spirit of responsibility to combat the deadly virus and is in solidarity with countries of the world.

Also The Central Bank of the UAE, CBUAE, has launched a Dh100 billion comprehensive targeted economic support scheme for retail and corporate customers affected by COVID-19. These measures will enter into force with immediate effect, according to a CBUAE statement issued Saturday.

“Given that the World Health Organisation has declared COVID-19 virus as a global pandemic, the Central Bank of the UAE has adopted a number of measures in an effort to support the economy and protect consumers,” reads the statement.

The Targeted Economic Support Scheme consists of Dh50 billion from the CBUAE funds through collateralised loans at zero cost to all banks operating in the UAE and of Dh 50 billion funds freed up from banks’ capital buffers.

“The UAE banking system is adequately capitalized and banks maintain significant voluntary capital buffers in addition to the minimum prudential requirements. The draw-down of those voluntary buffers is not considered for the purposes of calculating the overall size of the targeted economic support scheme,” added the statement.

Banks are expected to retain sound lending standards and are required to treat all their customers fairly. The purpose of the targeted scheme is to facilitate provision of temporary relief from the payments of principal and interest on outstanding loans for all affected private sector companies and retail customers in the UAE. Participating banks should use the funding to grant temporary relief to private sector corporate customers and retail clients for a period of up to 6 months. Many retail and corporate customers have become exposed to the risk of temporary shortfall of their cash flows due the outbreak of COVID-19 pandemic, and the scheme is addressing the current situation by providing both a relief to customers and a zero cost funding to banks.

All banks will be allowed to tap into a maximum of 60 per cent of the capital conservation buffer, and, additionally, banks designated as systemically important by the CBUAE will be able to use 100 per cent of their additional capital buffer for systemic importance.

The CBUAE is also reducing the amount of capital banks have to hold for their loans to SMEs by 15 to 25 per cent. This change, which is broadly in line with the minimum standards set by the Basel Committee, will facilitate further access of SMEs to financing.

To ease its macro-prudential stance, the CBUAE will increase the loan-to-value, LTV, ratios applicable to mortgage loans for first-time home buyers by 5 percentage points. This will contribute to the affordability of housing without unduly increasing inherent risks. First time buyers will benefit from being required to put up less of their own capital when making the first real estate purchase.

The CBUAE will also revise the existing limit which sets maximum exposure that banks can have to the real estate sector. When the exposure reaches 20 percent of the banks’ loan portfolio (measured by risk-weighted assets), banks will be allowed to increase it to 30 percent, but will be required to hold more capital.

Furthermore, the CBUAE will adopt new regulations with the objective to reduce fees incurred by merchants when their customers pay by debit or credit cards. The CBUAE will also issue new regulations which will limit fees banks charge to their SME customers, and stipulate that banks cannot require larger minimum account balance that Dh 10,000.

 

Additionally, the CBUAE will mandate all banks to open accounts for SME customers within a maximum timeframe of two days, provided acceptable documentation is in place and that the risk is acceptable in view of the AML and CTF obligations.

The CBUAE will issue guidelines on margin calls, requesting banks to always request additional collateral within a reasonable time, before liquidating the pledged stocks in a situation of market downfall. This would reduce excessive market volatility and provide investors with increased flexibility to act in their best interest.

Effective from 15 March 2020 and for a period of 6 months, the CBUAE has waived all fees which it charges for the payment services provided to banks operating in the UAE through its payment and settlement systems.

“The CBUAE will continue monitoring the situation very closely, and is prepared to take further steps, if necessary,” the statement concluded.

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Source: UAE suspends issuance of all entry visas from March 17 | Government – Gulf News

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Coronavirus: UAE suspends issuance of all visas, Measure to come into effect from March 17. The UAE on Saturday has decided to temporarily suspend the issuance of all visas from March 17 this year, except for the holders of diplomatic passports.
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