Sanford Health neurologist Dr. Jerome Freeman separates kindness from several other attributes commonly associated with humane health care by calling it an action. Kindness, at its roots, is something people do.
The chair of the University of South Dakota Sanford School of Medicine’s Department of Neurosciences wrote the book “Bringing Kindness to Medicine” and has written several articles explaining its importance to health care providers.
It goes beyond a call for a good bedside manner by Freeman’s definition, though that isn’t a bad place to start.
“Kindness is where the rubber meets the road,” Dr. Freeman said. “Kindness is what we do that makes a difference in people’s lives.”
The unique element in this effort is the degree to which the USD Sanford School of Medicine has embraced kindness as part of its core. It’s not just a chapter in a book or one course in a curriculum. Medical school dean Dr. Mary Nettleman has made it much more than that, initiating a five-point strategic plan to make kindness part of the fabric of the school.
This level of commitment, making kindness a centerpiece, is unique among medical schools.
“We’re inserting discussions about kindness into the curriculum,” Dr. Nettleman said. “We have asked our clinical faculty to bring up the topic of kindness and to recognize it if a student is being kind, or to relate a stories about kindness. Students in different areas of the curriculum, all the way through medical school, will hear about kindness.”
Kindness initiative starts the first day
The official introduction to medical school begins with what is known as the “White Coat Ceremony.” It is an occasion for recognition of the profession’s commitment to patients.
It presents a medical school with an opportunity to feature its highest ideals. At the most recent White Coat Ceremony at the University of South Dakota Sanford School of Medicine, Dr. Nettleman and Dr. Freeman both addressed the school’s commitment to kindness.
“The first thing we do is define it,” Dr. Nettleman said. “There are many attributes you want to see in a physician. You want them to be compassionate, you want them to have high integrity, you want them to be fair. We wanted to set kindness apart. Compassion is how you feel for somebody; kindness is what you do for somebody. I wanted to set that in context at the White Coat Ceremony.”
Within a profession that depends so much on a culture of cooperation, kindness is most valuable when it goes out in all directions. That applies both to health care’s necessarily collaborative environment, and more specifically in this case, the significant demands of medical school.
“The expectation is that we’re going to imbue a notion of kindness and the importance of kindness throughout the school to students, staff and faculty,” Dr. Freeman said. “We’ve been doing this for more than half a year now and we’re very pleased with how things are going.”
Creating a core value
Dr. Nettleman and Dr. Freeman both emphasized that this is not an administration-generated directive to be aimed exclusively at students. It is not: “You are going to do this.” It is: “We are going to do this.” It’s an intriguing part of the equation.
“What attracted me to this was that we could take something nebulous like kindness, something that might differ based on cultural norms, or even person-to-person, and make it a core value,” said Claire Porter, a second-year medical student from Rapid City who was part of a focus group involving the kindness initiative. “To me, making something a core value is concrete. I’m thinking, ‘How can we measure that?’ I was really interested in that idea.”
Medical students and physicians are by nature, and in practice, already kind, Nettleman said. It is also a defining feature of the region, in her opinion. As one who has had several career stops outside the region, she’s earned the right to make comparisons.
“If you live here long enough you realize kindness is a South Dakota characteristic,” Dr. Nettleman said. “It’s one of the things that defines South Dakotans. So when our students come to school here, they’re altruistic and they’re enthusiastic. When they graduate, we want them to keep that.”
Handling the challenges
But medical school is hard. Its inherent demands can make it more difficult to consistently deliver those qualities. That’s where kindness comes in.
“It is the thread that ties it all together,” Dr. Nettleman said. “It is thinking about other people in an intentional fashion. What can I do to make people’s lives better? For us, it’s a way to start with this wonderful group of students and end up with people who are inspired to care for others when they leave.”
As an example of the benefits of kindness, Dr. Freeman introduced the following example:
A doctor with important information goes into a patient’s room, stands at the foot of the bed and makes a pronouncement. Or, the same doctor goes into the room, sits down next to the bed, interacts with the patient on a human level and relays that same information.
It’s obvious the latter scenario is more kind. Not so obvious is the far-reaching impact simple gestures can have on a patient and those close to them.
“It doesn’t take much time to be kind,” Dr. Freeman said. “And part of the power of kindness is how it’s amplified. If a patient or a family feels like they’re being treated kindly, they talk about it over and over. They lift it up as an example. As a cautionary note, they do the same if they’re treated unkindly.”
Taking kindness with you
For many medical school students, the initiative has served as a confirmation that they’ve chosen the right profession. The idea that kindness will continue to be a valued attribute is an appealing part of their future.
“To me, something that motivates me to want to go study for eight hours a day is knowing I’ll have a career that is in accordance with my values as a person and allows me to live out those values,” Porter said. “A kindness initiative, when it’s the gold standard, is a way for medical students to practice kindness for four years so that we can build habits to carry into our professional career.”
And put another way:
“People want competent doctors who are also kind,” Dr. Nettleman said. “When you have a lot of patients to see and have a lot of things going on, we want our doctors to remind themselves to do things kindly. Sometimes that becomes more difficult, but if it’s an intentional part of your day, it becomes part of your DNA.”
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