Every patient wants to be treated with dignity. However, when you are sitting in a doctor’s exam room, holding together a hospital gown that somehow does not want to completely fit around you, or close properly, it is difficult to feel that you have any dignity. When the doctor comes into the room and barely listens to you or looks at you, while he or she is checking your health record on the computer, it also feels as though you do not have much dignity. When the doctor explains the treatment options for your problem and does not take the time to listen to you analyze your issues, a culture of dignity is missing from this interaction.
Donna Hicks, PhD, an associate at the Weatherhead Center for International Affairs at Harvard University, has worked for over a decade in the field of international conflict resolution and has published a sentinel book called Dignity, its Essential Role in Resolving Conflict. Although the book is focused on a culture of dignity in the workplace, there are many parallels that are essential to health care organizations and health care professionals who strive to offer quality care.
The ten elements of dignity that Dr. Hicks outlines in her book, so relevant in a health care setting include:
1. Acceptance of every person’s individuality and identity.
2. Inclusion – making people feel they belong.
3. Safety – putting people at ease.
4. Acknowledgment -giving people full attention by listening, hearing, validating and responding to their concerns, feelings and experiences.
5. Recognition – validating others for their personal traits and talents.
6. Fairness – Treating people equally.
7. Benefit of the doubt – trusting people.
8. Understanding – believing what others think matters.
9. Independence – Encouraging people to act on their own behalf – empowerment.
10. Accountability – taking responsibility for actions.
There are a plethora of patient stories where doctors ignore the patient’s point of view or explanation of what is wrong. There are frequent instances when doctors in the exam room fail to communicate with their patients or even look them in the eye. There are countless times when intentionally or unintentionally healthcare professionals strip away a patient’s sense of dignity by patronizing them.
Duncan Cross, a patient who has suffered with Crohns disease for a number of years wrote a blog post that describes his first-time encounter with a gastroenterologist. He talks about this physician’s attitude and equates it to the attitude of folks who ran segregated lunch counters many years ago, attitudes that are no longer acceptable. He discusses this physician’s refusal to take him seriously when he described the pain he was suffering, because certain markers were not present to indicate that pain. He appeals to the physician, in a letter, to view patients as equal partners in their care, something that this physician clearly did not do. What Duncan advocates is the essence of what it means for healthcare professionals – doctors, nurses, nurse practitioners, therapists and physician assistants to treat patients with dignity.
So how do physicians and hospitals consciously create a culture incorporates the ten elements of dignity?
At Mount Auburn Hospital, in Cambridge, MA, the Dignity Matters campaign was launched last year to instill in everyone from the Executive Suite to the Environmental Services department how important it is to recognize the practice of treating everyone, including patients, with dignity. Initiated by the Past President of the Medical Staff, Dr. Anne d’Avenas, the program was launched with a series of workshops where hospital, professional and administrative staff participated in a presentations/discussions, followed by breakout sessions which focused on various scenarios that illustrate lessons learned about treating colleagues, patients, family and visitors with dignity. Using buttons, posters and flyers, the Dignity Matters campaign is visible throughout all of Mount Auburn’s affiliated offices. There is a plan to incorporate Dignity Matters into the Mount Auburn web site.
In today’s stressful world it is difficult to maintain a culture of compassion and respect throughout the health care system. It is even more challenging to improve the patient experience and increase satisfaction by insuring that we are all treated with the dignity each of us is automatically entitled to.