#102: Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference

A 34-year-old man fighting for his life in the intensive care unit is on an artificial respirator for over a month. Could it be that his chance of getting off the respirator is not how much his nurses know, but rather how much they care?

A 75-year-old woman is heroically saved by a major trauma center, only to be discharged and fatally struck by a car while walking home from the hospital. Could a lack of compassion from the hospital staff have been a factor in her death?

Compelling new research shows that health care is in the midst of a compassion crisis. But the pivotal question is this: Does compassion really matter?

In Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference, physician scientists Stephen Trzeciak and Anthony Mazzarelli uncover the eye-opening data that compassion could be a wonder drug for the 21st century.

This episode is packed with practical insights and ROI evidence for customer experience investment.

Join me and my guest, Dr. Stephen Trzeciak, author, Ted Talk speaker, and, oh yeah, Chief of Medicine at Cooper University Healthcare.

In this episode:

  • Evidence-Based Compassion: Compassion in healthcare isn’t just a moral imperative; it has measurable, impactful benefits. Studies show that even a 40-second compassionate intervention can significantly reduce patient anxiety.
  • ROI of Compassion: Compassionate care doesn’t just improve patient trust and outcomes; it also positively affects hospital revenue, reduces staff turnover, and enhances overall service quality. Compassionate hospitals achieve better patient loyalty and team cohesion.
  • Combatting Burnout: Dr. Trzeciak highlights the inverse correlation between compassion and burnout. Genuine, compassionate relationships are key to fostering resilience and well-being among healthcare providers, ultimately improving team retention and reducing costs related to high turnover.

Meet Dr. T

Stephen Trzeciak, MD, MPH is a physician scientist, the Edward D. Viner Endowed Chief of Medicine at Cooper University Health Care, and Professor and Chair of Medicine at Cooper Medical School of Rowan University in Camden, New Jersey. Dr. Trzeciak is a practicing intensivist (specialist in intensive care medicine), and a clinical researcher with more than 100 publications in the scientific literature. His scientific program has been supported by research grants from the National Institutes of Health and the Agency for Healthcare Research and Quality, with Dr. Trzeciak serving as Principal Investigator. Dr. Trzeciak is the co-author of two books, Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference (2019), and Wonder Drug: 7 Scientifically Proven Ways That Serving Others Is the Best Medicine for Yourself (2022). Broadly, Dr. Trzeciak’s mission is to raise compassion globally, through science.

Transcript

Mark Slatin:
The number one challenge of any CX leader is getting executive buy-in. Without it, CX practices are destined to fail. If you’re a CX leader, then you’re a change leader, and you know the frustration when you don’t have the support you need. That’s why I developed the Trusted Guide Roadmap Masterclass. It’s unique because it’s live, interpersonal, hands-on, and we give you proven frameworks, tools, calculators, and resources to empower you to effectively lead change. Enrollment is now open for this quarter’s masterclass starting October 16th. Don’t miss your chance to join us. To learn more, visit empoweredcx.com. Welcome to the Delighted Customers Podcast, now part of the Agile Brand Podcast Network. I’m your host, Mark Slatin, and I’m thrilled to have you join us. My mission is to empower leaders to delight their customers. Each episode, I bring on guests from diverse backgrounds who share valuable insights, wisdom, and practical tips that you can apply right away. Well, this is an extra special edition of the Delighted Customers podcast today. I love to get into the world of healthcare medicine, and we have a very special guest on the show today, Dr. Steven Trzeciak, Dr. T, I’ll call him, who is a physician scientist, professor, and chair of medicine at Cooper Medical School of Rowan University, and the chief of medicine at Cooper University Healthcare. Dr. T is a practicing intensivist, which is a specialist in intensive care medicine. And it’s easier for me to say than do because I just feign at the sight of blood. So a lot of respect for doing that. And a clinical researcher with more than 120 publications in the scientific literature, primarily in the field of resuscitation science. Dr. T’s publications have been featured in some of the most prestigious medical journals, such as JAMA, Circulation, the New England Journal of Medicine. And his scientific program has been supported by research grants from the American Heart Association, NIH. And he’s been, with him serving as the role of principal investigator. So with all that, Dr. Steve, welcome to the show.

Dr. Stephen Trzeciak: Thanks so much, Mark. I appreciate the invitation and look forward to the conversation.

Mark Slatin: So we’re talking about patient experience, um, really, uh, in our world, uh, customer experience management. And the way I came across you, I was recommended a book of yours was recommended to me by, uh, a doctor up at, uh, Tufts medical center. And it’s the book that I’m talking about is called Compassionomics. So if you would tell us, tell us if I missed anything about what you’re doing now, share that with what you’re up to these days. And also then share with us what the white space you saw in writing the book Compassionomics.

Dr. Stephen Trzeciak: Sure, I’d be happy to. So, my name is Steve Trzeciak. I teach at Cooper Medical School and I thank all your listeners for sharing their time with me today. I know it’s their most valuable commodity. So, I’m a physician scientist, as Mark said, and resuscitation science is the research around CPR and essentially bringing somebody back to life. Colleagues and I had grants from the NIH, National Institutes of Health, to try to find what was the optimal level of oxygen in the blood that would reduce the risk of permanent brain damage after somebody’s resuscitated from cardiac arrest. And then one day I got a call from my boss, the chief medical officer for the organization. who is also my colleague and co-author on Compassionomics, Dr. Anthony Mazzarelli, who’s now the co-president and CEO of our organization here at Cooper. And so he called me into his office and he said, you know what, we need to do better with patient experience. And you are our most productive researcher. And I need your help in convincing all of our academic doctors that we need to lean into patient experience and transform it. And so I need you to synthesize all the evidence on that. And I need you to science this up for me. And I said, you’re out of your mind. I do. I do brain injury after cardiac arrest. No, I don’t want to do that. But while we’ve been colleagues and friends for a long time, he also was my boss. And so this wasn’t a suggestion for my consideration. Right. So I thought I would just go ahead and dive into the evidence in a cursory way and come back to him with the evidence, with with with the answer. that there really wasn’t scientific evidence. It’s just the right thing to do. And what I found in that journey through the evidence, what he and I found together, is that treating patients the way they ought to be treated, the way that we would want to be treated ourselves, but specifically the core element of that is compassion, compassion for others. that compassion isn’t just the right thing to do, it’s also the smart thing to do. The papers that we discovered in our journey through the evidence that took us over a year probably made a splash at the time that they were published, or even a ripple, but no one had put them all together before to form a wave of scientific evidence that compassion isn’t just something that matters in meaningful ways, but also in measurable ways. And so that’s how compassionomics came about.

Mark Slatin: I can’t wait to dig into this some more because this is almost priority number one amongst CX professionals is talking about how to justify continued investment in customer experience initiatives. And you have explored this. And like you said, it sounds like your theory going in was, well, it’s just the right thing to do. the evidence showed something different. And we can’t wait to dig into some of those examples. I really like in the book, two things that come to mind right now. In the book you talked about, this is a great way to overview what we’re about to get into. The science of medicine is how to treat patients. The art of medicine is how to take care of them.

Dr. Stephen Trzeciak: That’s right. And it’s, we used to think of that, and I used to think of that as two separate circles, if you will, but it’s really a Venn diagram where there’s overlap, where there is evidence, what we call compassionomics, the science of compassion. And it’s that, the overlap of the Venn diagram between the science and the art of medicine, where the caring elements of healthcare actually make measurable differences for patients and for patient care, and even for those who care for patients. So I’d love to talk to you all about that science, but also how you get the ROI.

Mark Slatin: Yeah. And we, and we’d like to hear, um, a lot about that. Um, I’m so excited about this and I want to ask you about, um, I guess, I guess one of the things that comes to mind is you go in there, you’re, you’re going to be doing some research. You are a researcher. What surprised you most about what you discovered?

Dr. Stephen Trzeciak: What surprised me most was a very consistent signal in the data that compassion matters, as I said, in measurable ways. And there are really four different areas in which compassion can move the needle. Physiological effects of compassion for others, psychological effects. effects on how patients take care of themselves, so patient self-care, as well as effects on the quality of the care that we provide to patients. So in those four domains, we found that in total there are over a hundred papers. These are papers published in peer-reviewed scientific journals. that show that compassion makes a measurable difference. And what was striking for me is to see these not just ideas or feelings, but p-values and confidence intervals to measure the magnitude of the effect. Very similar to all the quantitative research that I had been doing earlier in my career.

Mark Slatin: So your research, and before I knew, I knew the question I was going to ask and I forgot. Now I’m going to ask it is to level set for the audience because something seemed kind of obvious, but what would you, since the book’s called Compassionomics, what would you, how would you define compassion?

Dr. Stephen Trzeciak: So compassion is defined this way by most of the people who do research in this field. An emotional response to another’s pain or suffering or struggle involving an authentic desire to help. So it is distinctly different from a very closely related word, empathy. So empathy is the sensing, feeling, detecting, and understanding another person’s pain, suffering, or struggle. But compassion goes beyond that to take responsive action in some way to try to alleviate their pain, suffering, or struggle to whatever extent may be possible. there are actually robust neuroscience data to explain this distinction in terms. So it’s not just semantics. Using a brain imaging modality called functional MRI, neuroscience researchers have been able to see what part of the brain is activated at any given moment in time. And when your brain is focused on Helping and serving others. There is a distinct neural structure activated It’s different from when you have empathy meaning you just bear witness to pain and suffering that actually activates the pain center of your brain and We know this experientially because it’s very uncomfortable to watch people suffer So there is neuroscience data behind the saying I feel your pain But when your mind is focused on taking action to find ways to help and to serve others and alleviate what they’re going through, it’s a distinctly different neural structure, a different part of the brain that lights up. It’s what neuroscience researchers call a reward center of the brain reward center. So it’s associated with positive affect, positive emotion, feelings of affiliation. And it’s part of the reason why it feels good to help people.

Mark Slatin: That’s that’s powerful stuff. So I like to pull gems out. from our guests as we’re going through it. And this one is worth, even though it wasn’t medical language, thank you. It was pretty straightforward. In the CX world, we talk about serving others well and making a difference in their lives. And I completely believe that we really can easily underestimate the amount of interactions people have and the amount of experiences people have in a given day. And by having either a good or a bad experience, it could really shift the trajectory of their day and affect the circles in a ripple effect around them. What you’re adding to that is the impact it has on you, the giver.

Dr. Stephen Trzeciak: Yeah, this is where the science meets the personal for me. So burnout is a term that a lot of people are familiar with and often associated with frontline healthcare workers. And let me be crystal clear about one thing, and this is important. You don’t have to be a healthcare worker to be burned out. That’s just the population of people in which much of the research has been done. But there’s nothing unique about being a person who puts on scrubs to go work in a hospital in the morning. Uh, so you, Everybody can experience burnout, especially after years of a pandemic. So burnout is everywhere. But for me, it was at this time, 15 years after I started working in the ICU, and I became keenly aware that I had every symptom of burnout myself. We often meet people on the worst day of their life. And after 15 years of doing that, I had all three components of the burnout syndrome. It’s emotional exhaustion, the feeling like you can’t really make a difference, and then depersonalization, which is a difficulty or inability making personal connections. I was batting three for three there. And when I was going through burnout, this is how much of a research nerd I am. I actually went to PubMed, which is like Google for the medical science. And I tried to figure out, well, what do I do? And The conventional thinking at the time was take more nature walks by yourself and do hot yoga and put on your headphones and block out the world and put on your meditation app and all those things. And there’s nothing wrong with those things. Or take more vacations as if just getting away from my patients as much as possible was the solution. Of course, that’s not even sustainable. And so I thought all of that was escapism, escapism. And I thought that that can’t be the answer. There has to be something that changes fundamentally at the point of care. And that’s when we started doing our work on compassionomics. And I got to see the evidence for myself. When I was in medical school, and this is in the 90s, I remember being taught, don’t care too much, because too much caring, too much compassion burns you out. And I believed that dogma for 25 years because I never thought to question it until I was in the throes of burnout myself. And I looked into the evidence and imagined my surprise when I saw the signal that there was in fact an association between compassion and burnout, but it’s inverse. It’s inverse. So where stories and conjecture and anecdotes once reigned back in the 90s when I was in medical school, now there was bona fide peer-reviewed published scientific literature, and it showed an inverse association. So if what I was taught in medical school was true, it’d be high compassion, high burnout, low compassion, low burnout. But what you see in the published evidence, 80% of the published data, a preponderance for sure, shows an inverse association. So it’s high compassion, low burnout, low compassion, high burnout. Why? Well, if it’s one thing that Dr. Maz and I have learned over our work in compassionomics or our more recent projects, it is this. The key to resilience is relationships. The key to resilience is relationships. And so I decided that I was going to do my end of one experiment. So there’s just one study subject. And in this experiment, I decided I was going to care more, not less lean in rather than detach and pull back. And not just with my patients and their families in the ICU, but with the nurses that I had worked with for 15 years at that point, with my trainees, with my colleagues, and even at home. And I got all the deeper relationships that flowed from that. And that was when the fog of burnout began to lift for me. It changed everything. And so if your listeners are feeling like they’re going through burnout, My evidence based recommendation for them to consider is to test the compassion hypothesis for themselves, lean into their relationships. And, um, and it changed everything for me. It can change everything for them too.

Mark Slatin: And that’s a prescription from the doctor on the delighted customers podcast. Steve, I want to read a, uh, an excerpt, another excerpt from the book, if it’s okay. And then ask you a question. So you say in the book, you say if these clinical interactions are devoid of compassion, the relationship between caregiver and patient could become essentially no different than any other customer service relationship that just can’t be allowed to happen. Why not? Health care needs to be a calling. Walking with people through the worst, most intimate moments of their lives is a sacred That requires a level of personal interest and investment by health care workers. When patient’s health and well-being is at stake, time, emotion, empathy, and compassion should be non-negotiable. But multiple studies indicate that many health care providers aren’t even hearing their patients’ worries. So it’s no wonder that many patients experience lack compassion. What is going on? What is the problem?

Dr. Stephen Trzeciak: First of all, I think that caring is an important component of all of serving others just broadly, whether it’s customer experience, patient experience, serving others in our communities. In fact, Dr. Maz and I just finished another book about serving others and the science of serving others is the best medicine for yourself. And so I want to be clear that while I think in the context of health care, the relationships are different. I believe compassion and caring are similarly important in the way we serve our customers just broadly. Medicine, and especially what I do for a living in the intensive care unit, there is some uniqueness. You know, as I said, we meet patients and their families on what is often the worst day of their life. And they face end of life decision-making, life-threatening things. So there is uniqueness here. What we’re trying to get at in that passage is that you have to, um, have a respect, uh, for there, there is a, there is a sacred, uh, experience there when, when you connect with somebody, when their life is on the line and their families and their loved ones are filled with hope, um, there is uniqueness there. And, and what we, what we were referring to with the data is that the, Published research shows that in visits to a doctor’s office, the time to first interruption of a patient while they’re trying to state the reason why they came for the visit is just 22 seconds. And in fact, that number seems to be dropping as more investigators study it over time. And if we’re not even willing to listen to what it is that people have to say before interrupting them, then clearly they get the message that, that we’re not interested. And so the data on interruptions and, um, versus just letting people talk and, and, and really listening, um, as opposed to, um, just going through the motions, these are just vital to building a relationship.

Mark Slatin: And so to connect the dots here in the book, you talk about the power of 40 seconds. Um, can you, can you elaborate on that?

Dr. Stephen Trzeciak: Sure. So we try to be evidence-based about everything that we do in our work. And so there was, there were, I’ll give you another striking number besides 40, 56. So that was the proportion of respondents in a research study published in the Journal of General Internal Medicine. 56% of doctors said that they don’t have time to treat their patients with compassion. 56% of doctors said that they don’t have time to treat their patients with compassion. Besides the shocking nature of that statistic, in my opinion, what’s the evidence? I mean, it begs the question, how much time does it really take? So a group of investigators from Johns Hopkins University wanted to test that. And they did it in the context of 210 patients, most of whom were survivors of breast cancer. And the outcome measure for this study was patient anxiety. Now, if you’ve ever had cancer or someone close to you has had cancer, you know that anxiety is a pretty important outcome measure. And so what they were testing was a conventional information only consultation with an oncologist, a cancer specialist. versus the same information from the oncologist with just a little bit more. And what they found is that the little bit more, what they called the enhanced compassion intervention, had not just a measurable, a statistically significant reduction in the cancer survivors’ anxiety levels. So what was the intervention? The intervention was things like this. I know this is a tough experience for you, and I want you to know that I’m here with you. Some things I say today may be confusing and I want you to feel comfortable in stopping me if something doesn’t make sense. I want you to know that we’re here together and we’re gonna go through this together. And then at the end of the consultation, the oncologist said again, I want you to know that I’m here with you. I’ll be with you each step along the way. And so what the researchers found when they, after the results of finding that this had a statistically significant reduction, improvement, lowering that is, in the patient’s anxiety level, they measured how long that intervention took on average. And it was 40 seconds. And so if we’re going to be evidence-based about it, rather than saying, I don’t have time, if we’re gonna be evidence-based about it, the evidence shows that at least just for a little bit of meaningful connection that can make a difference, it only takes 40 seconds. Now, of course, if you have multiple moments, yes, it could grow into something larger than that. But just for the, just for a measurable unit, 40 seconds may be all that it takes. And now some of my colleagues, they really bristle it when I talk about this. They actually hate it because they say, really, There should be no time dimension at all, because in reality, you can go through your day with brusque efficiency, letting everybody know how busy you are or how busy you think you are. Or you could treat people with compassion and kindness. And if I held a stopwatch to you, it’d be negligible what the difference was.

Mark Slatin: So if we just took a little bit more time to be to show compassion, the benefits are not just little. They’re statistically significant.

Dr. Stephen Trzeciak: Well, I’ll tell you, um, there’s even evidence that, that there may be no time dimension at all. So a study from the university of Pennsylvania randomized people to these were, this was not in the context of healthcare. This is a psychology experiment. Okay. The primary outcome measure was the, the, the subjects feeling of, time affluence, time affluence. They coined that term to represent somebody’s feeling of having plenty of time. They’re not in a hurry. We know what that feels like versus when we feel rushed. Right. And so they randomized people to four different uses of time to ask the question, what uses of time change how you feel about the time that you have? And they randomized them to, number one, spending time on yourself. Number two, getting a windfall of unexpected free time. Number three was wasting time. And the fourth one was the only one that made a measurable difference to raise somebody’s feeling of time affluence. And that was spending time helping other people. So if we’re going to be evidence-based about it, there’s something about spending time on other people that makes you feel differently about the time that you actually have.

Mark Slatin: That is powerful. Win-win situation. It does remind me of, and it begs the question for me, doesn’t that have a positive impact on trust? Trust between, you know, the feeling of trustworthiness that the patient has for the doctor and connecting the dots between, you know, the likelihood to continue the treatment, the likelihood to feel less anxiety. Am I on par with that?

Dr. Stephen Trzeciak: Absolutely. So one of those four domains that I told you for effects on patients, it was physiological, psychological effects on quality of care. The last one was effects on patient self care. So that’s how patients take care of themselves. So in the medical science, we typically refer to adherence. That’s the term that we use for the strict, uh, how strictly a patient either follows or does not follow recommended guidelines. What the research shows, in the preponderance of the published evidence shows that if you care deeply about patients and they know it, they feel it, they’re more likely to take their medicine. They’re more likely to follow treatment recommendations. They’re more likely to follow your recommended therapies and they’re less likely to be lost to follow-up, meaning they’re less likely to never come back. And so there’s something intuitive about that. If we treat people the right way, the way we would want to be treated ourselves, that they’re going to trust you more, but also they’re going to have more buy-in because the opposite of this is where they don’t feel cared for. They feel like their doctor or nurse, nurse practitioner, they feel like they don’t care. Well, then why would I even bother to go back there? And people can get hurt if they never come back. If people get hurt, or if people never come back, they might never get their colonoscopy for cancer screening, or they may never get, they may never finish their treatment and be untreated. And whatever’s brewing in them can go unchecked. So it can be really harmful. And so the trust is powerful. And the mediating factor is adherence to therapy and just buying in to the plan.

Mark Slatin: I think all roads kind of lead to this point we talked about at the top, which is proving the ROI for continued investment from senior management. And we talked about the benefits to the healthcare providers. We talked about the benefits to the patients. If I’m the CEO of the hospital, I’m looking at the financials, I’m looking at the bottom line. What can you share that you have done successfully or believe that others can utilize successfully to make the business case for service here in terms of compassionomics? And why haven’t senior leaders cared more up until now?

Dr. Stephen Trzeciak: Two things. And then I’ll get to the senior leaders part in a second, but there’s two things. One’s in revenue and one’s in expense. In revenue, it is patient experience drives business. Patient experience drives business. How many times have you heard about someone’s experience with a physician and it was absolutely awful? Would you ever go back? Would you ever go make an appointment with them? Of course not. And on the contrary, a person’s experience with a physician that was really good goes a long way into them also wanting to see that physician. But I want to be evidence-based about everything that we do. And so the evidence, for example, a study was just published, 14 different emergency departments across Canada, where they measured the compassion, or actually they measured the patient’s experience of their entire emergency department visit. And what they found is that the number one driver of all potential drivers to the patient’s experience of the quality of care that they received was how much compassion they got from the caregivers in the emergency department. So caring and compassion drive patient experience, patient experience drives business. Excuse me. And there are many more data behind that that we could go through. The other one is an expense, and this is a big one. Our health system and every health system in the U.S., I’m willing to bet, has the number one on their expense line is people. People, right? And one of the major drivers of higher expense with people is the churn. of people in and out of the industry or in and out of different health systems, losing people. Right now in health care, we have a demographic drought that was coming. It was we knew it was coming before the pandemic and the pandemic just accelerated that, which now just leaves a lot more stress and workload on the people who are left behind. We cannot afford to lose anybody right now, especially the people who are good.

Mark Slatin: Well, what’s the what’s the demographic that we’re losing?

Dr. Stephen Trzeciak: So, uh, when I talk, what I mean by demographic drought is just a sheer numbers of, of, uh, healthcare workers where this clearly was coming for years, but now it’s just sharply accelerated. So where we, where we lost the most people were the people who were closest to retirement when the pandemic hit and then they just tapped out. Um, and also, uh, the strain of the pandemic, uh, made some people reconsider their choice to go into healthcare. And so that, that is broadly across all the different demographics that make up healthcare workers. But the churn and the turnover and losing people due to burnout, as we’ve been talking about among many other things, is extraordinarily expensive. And so in compassionomics, the key principles aren’t just compassion for patients, and for patient care and for those who care for patients, but how we take care of each other, how we take care of each other. So for example, there was a study by McKinsey and Company just recently that studied many different professions, but in healthcare, they studied nurses. And what they found is a huge proportion of nurses were considering leaving healthcare or leaving their employer over the next 24 months. And when they asked the employers what was the drivers of that, the employers of course thought it was pay or it was workload. And those things were drivers to some extent, but they weren’t the sharpest discriminators. The sharpest discriminators were two things. Number one, having caring and trusting teammates. And number two was a sense of belonging. Having caring and trusting teammates and a sense of belonging. So our compassion for each other and how we take care of each other has a huge impact on the propensity for people to want to leave, which is one of the major drivers and of expense in any health care organization, including ours. And so I think that much of the ROI is in holding our teams together because it’s It’s like a it compounds upon itself, meaning I always say if we take good care of each other, how we take care of patients will be just fine. But the truth is, the more we show compassion for our patients will also be in the right mindset to show compassion for each other. And holding our teams together is vital always, but it’s even more vital right now.

Mark Slatin: Yeah, well, that’s that’s powerful. And That’s a great segue to to really the last question that I want to ask before the final question that I ask all my guests, which is great. And I want to let the audience know having read the book that there are a lot of great examples and illustrations in the book around this idea of ROI of PX, CX, fantastic stories, well-written, digestible, even, you know, if I could read it, you could read it. But if you’re a CX leader or in that world of delivering experiences for customers or patients, you must read this book, Compassionomics. So the question is, and maybe you’ve already hit on it, but if you could sort of crystallize it for the audience, share a few strategies that people in healthcare or other industries can use to raise the bar with compassionomics mindset, and maybe a starting point or one that’s connected, because I want to come back to this, because I feel like you brought up such a good illustration before that I don’t want to roll over it, but that example of what to do when someone’s dealing with a potentially life-threatening or a very, very grave diagnosis or they’ve come in, and just the way you walk through, I’m here for you, I’ll be with you every step of the way, seems like basics, but it just makes a world of difference. So with that, maybe that’s why, maybe it’s not, but what are some strategies that you might share with the audience?

Dr. Stephen Trzeciak: Sure, well, there are three things, and we’ve already gone over the first two. The first one is realizing that there is, in fact, an evidence base for compassion. Compassion is not just a nice to have, it’s actually a vital part of not just healthcare, but health and healing. Once you realize that there is, in fact, published rigorous scientific evidence behind compassion, you feel differently about your opportunities to use compassion. So that’s number one. Number two is it’s all about time. And we already covered that. So 40 seconds, if we want to be evidence based, just to show a little bit, but meaningful and measurable difference. And so it doesn’t take as much time as we actually think. Number three is, and this might sound like a pithy bumper sticker, but it’s not. Okay. Number three is change is possible. Change is possible. And I didn’t believe that when I first started that work. I thought people were either wired for compassion or they’re not. Like it’s something that’s in their DNA or the fabric of who they are or not. And that’s until I actually went through the scientific evidence and saw a very different signal, both within the healthcare domain and far outside the healthcare domain as well. What the research shows is that change is possible. We can in fact get better at compassionate behaviors, how we behave towards another person. So we’re not talking about what you think in your mind or feel in your heart, but how you behave towards another person. The data are quite clear. My group’s published on this as well. About three quarters of the curricula for empathy and compassion training for physicians move the needle in some measurable way, and often from the patient perspective. And so Change is in fact possible. This is good news for me, indeed, because I am definitely a work in progress. But a key element of this, a key element is recognizing that change is possible. And so many of your listeners are probably familiar with the concept of growth mindset, popularized by Carol Dweck and her colleagues at Stanford, among many others. And the The growth mindset is when you look at whatever you’re trying to learn or conquer as a need for a set of skills rather than a trait. A person who has a fixed mindset says, this is a trait, either I have it or I don’t. So if I experience difficulty or struggle, I’m going to internalize that and feel like I failed. If you have a growth mindset, that means you just see everything as a set of skills that you just need to practice and get better at. And what Dr. Dweck’s work has shown that kids coming up through the educational system, they’ll have more success if they have a growth mindset because they won’t give up when the going gets tough. But what many people don’t know about her work is she and her colleagues also studied this for compassion and she found the exact same results. So the people with the growth mindset and they view compassion for others and human connection, whether it’s in PX or CX, if you view that as a collection of skills, therefore you just need to practice and get better at it. Those are the people who will put in the work and they can get better and then they do. The people who have a fixed mindset and think it’s a trait, either I’m born with it or not, they’ll never put in the work. And so they can’t get better at compassion, especially when compassion is hard. And let’s face it, sometimes compassion is hard. The last part of your question was about, you know, those very tough moments when someone’s going through a really intense struggle, perhaps the worst day of their life. And the best advice that I ever got was from a friend of mine who is now a retired pastor, but he used to make a lot of sick calls in the hospital. And one day he said to me, what is it with you doctors? You doctors feel like you always have to talk, like there’s silence in the room and you think it’s uncomfortable at a tough moment, so you just keep yapping. Why don’t you realize that Sometimes you just need to sit with people in their suffering and he called it the power of presence because Sitting with people in their suffering says far more than you could ever say with your words. It says you’re not going to go through this alone I’m gonna be with you And it says more than your words ever could say. And it’s powerful and sometimes even therapeutic. And so what I’ve learned is and this is how he framed it to me many years ago, just show up and shut up and just be present for somebody. And you’re being present for somebody will say far more than you ever could with your mouth.

Mark Slatin: Got all kinds of bumper stickers out of this show. Yeah, show up and shut up. Hey, I want to ask you the final question, but I have to ask you, since you do what you do, and before you got into this, you were studying CPR and life-saving impact of oxygen, for example, there could be somebody listening to this recording one day that is in a situation where they can make a difference. They’re put in a situation where somebody needs CPR or life-saving What do we learn, did you learn, that may not be as public or we may not be aware of through your studies of CPR and life-saving activities?

Dr. Stephen Trzeciak: I love the question. I’ve never been asked that before, by the way. Thank you. If there’s one thing that I learned through 15 years of studying resuscitation science, so that’s cardiopulmonary resuscitation for somebody who suffered a cardiac arrest, we can come up with all the different innovative cutting edge modalities to try to save brain function in the hospital. And none of it will matter if they got lousy CPR or no CPR. And I’m talking about bystander CPR. I’m not talking about the medics when the ambulance arrives. I’m talking about bystander CPR, the CPR training that is for everybody, the general public. And so it is amazing to me, the ones who I thought never could wake up again who do, I always go back and look at the record and somebody was right there on the scene trained in CPR. That makes more difference than anything I can do in my ICU. So thank you for the question. As I said, I’ve never been asked it before. The moral of that story is get trained in CPR because you can make a bigger difference than me. And I went to school until I was like 30 something years old.

Mark Slatin: Hmm. All right. Well, I’m glad I asked it. It’s just on my mind. And now I’m going to ask maybe you mentioned 30 years old. would, would you rewind the clock for us and go back to when you were 20 years old? And what advice would you give to yourself?

Dr. Stephen Trzeciak: Oh, boy. I would, I think I would shake my old self and say, Hey, man, listen, it’s not all about you. All right. It’s not all about you. And I might just leave it at that. I could go into a whole lot of other things. But I think that would probably be the most important message I could give my 20 year old self.

Mark Slatin: Yeah. So, um, I so appreciate your humility. Um, I, I hope that there are doctors that, that will, and healthcare providers in general who will have the same level of humility when thinking about compassion and providing that kind of care. And I just want to make the point from my experience of X number of decades doing CX and, and sales before that, um, how, important it is and how much it makes a difference to listen, to ask questions, and to not sell and tell, but really to affirm that this concept of compassion extends way beyond just health care.

Dr. Stephen Trzeciak: Mark, can I ask you a question?

Mark Slatin: Absolutely. It’s not medical.

Dr. Stephen Trzeciak: Yeah. So for what you just said, did it also transform your experience while you were doing all those things?

Mark Slatin: When I paid attention to it and I did it, when I did listen and ask questions 100%, 100% and try to be there and serve. When I got caught up in my own stuff and worried about what I was gonna say, how it was gonna look, making the sale or persuading someone to my way of thinking, it tend to fray the relationship.

Dr. Stephen Trzeciak: Well, I was just going to say, uh, what the research shows, uh, is born out in your end of one experiment because the key to resilience is relationships. So, um, that’s what it’s all about, but it’s not just a saying, right. It’s, it’s actually backed up by tons of, uh, scientific evidence.

Mark Slatin: Well, Dr. T, thank you so much for being a guest on the show. If, if someone wants to get ahold of you, or we just mentioned the one book, I know you’ve written another one, and maybe now another one on the way, what would be the best way for them to connect with you?

Dr. Stephen Trzeciak: Sure. So, uh, through the portal for our latest book, which is actually for those of your listeners who are not in healthcare, which is probably a big proportion of them. We wrote a book called wonder drug, and it is the scientific evidence that serving others is the best medicine for yourself. So that applies broadly. It’s basically compassionomics for everybody else meaning all those people not in health care and There’s a contact portal through that website. It’s wonder drug book calm Love it.

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