Updating the Definition for Humanism in Healthcare: Kind,Safe,and Trustworthy

In this increasingly challenging and chaotic time for medicine, humanism serves as an essential touchpoint. Humanism not only reminds us of the meaning of our work, it is a critical part of the solution for what plagues healthcare.

Humanism is a key driver for healthcare that is financially stable, ¹ improves patient outcomes ² and satisfaction, ³ and supports clinician well-being. ⁴ Humanism is at the core of the best healthcare.

But what is “humanism”?

Is it simply compassion? Empathy? Respect? Or is it all of those, and more?

According to Webster's Dictionary, ⁵ humanism is “a doctrine, attitude, or way of life centered on human interests or values.” We need a concrete definition for healthcare that can serve as a useful guide in daily interactions.

The Arnold P. Gold Foundation defines humanism as: “clinically excellent care that is kind, safe, and trustworthy.” The national nonprofit has been championing humanism in healthcare since 1988, and this updated definition taps into the latest knowledge of optimal care, as well as modern concerns about the healthcare industry.

This definition begins with “clinically excellent care” because technically accurate facts and a scientifically backed knowledge of medicine are essential to the best healthcare. Clinical excellence is a prerequisite for humanistic care—necessary, but not sufficient.

Adding kindness, safety, and trustworthiness takes clinically excellent care to the next level. These 3 elements turn technically accurate care into humanistic care.

Trust is at the heart of the best care and is what is most missing in today's healthcare environment. When patients trust their healthcare team, they are more likely to follow treatment plans and attend regular check-ups. They are more likely to share concerns.

A study published in the Journal of General Internal Medicine ⁶ found that patients with a strong sense of trust in their physicians had fewer hospitalizations and lower overall healthcare costs. Trust fosters a collaborative relationship that can prevent the escalation of minor issues into major health crises.

Trust, however, doesn’t happen automatically. A study published in JAMA Network Open study ⁷ found that 60% to 80% of patients do not tell the whole story to their healthcare professional. The most common reason was they did not feel that the person was able to hear the information without judgment.

Trust is also hard to regain. In focus groups held by Deloitte ⁸ of more than 500 Black, Hispanic, Asian, or Native American people, 55% reported a negative experience in which they lost trust in a healthcare professional. After such an experience, 4 of 5 people reported there was nothing the health system could do to make them return.

Safety is a second cornerstone of humanistic care and an effective healthcare system. Safety and trust are very much linked. In the Deloitte focus groups, ⁷ 36% of patients reported skipping or avoiding care because they did not like the way the healthcare professional or staff treated them. Patients do not feel safe when they fear they will be judged, embarrassed, and shamed when they share health-related information, such as their exercise or drinking habits, their weight, or their adherence to the treatment plan or medication.

When patients do feel safe in their care environment, they are more likely to engage openly and take part in treatment recommendations.

The Agency for Healthcare Research and Quality (AHRQ) ⁹ has documented that safety protocols addressing historical adversity and trauma in a patient's life can significantly reduce medical errors and adverse events. These reductions lead to fewer complications, less litigation, and lower costs associated with managing preventable conditions. A safer environment not only protects patients but also contributes to financial savings for healthcare systems.

Safety also influences the healthcare team in significant ways. Healthcare professionals need to feel safe in order to freely admit to errors or uncertainty; or to seek care they themselves may need, such as mental health treatment. Unfortunately, in many places, clinicians face the danger of losing their medical licenses or credentials after seeking mental healthcare or reporting such past care.

Kindness is the third essential element of humanistic healthcare, which often manifests as genuine concern for a patient's well-being. Kindness plays a vital role in enhancing patient experience and outcomes, as well as clinician well-being.

Research ¹⁰ indicates that patients who receive kind and considerate care are more likely to have positive health outcomes. These outcomes include better management of chronic conditions and a higher likelihood of engaging in preventive care. By fostering a culture of kindness, healthcare systems can reduce the need for more intensive and costly treatments down the line as well as less utilization of emergency room services.

Other words are often used interchangeably with kindness, most commonly “compassion.” The word “compassion” comes from ¹¹ the Latin root “passio,” meaning “to suffer,” and “com,” meaning “with.”

While suffering with someone can be an empathic and powerful act, the Gold Foundation seeks a more expansive perspective. Healthcare is more than suffering.

“Kind” is defined ¹² as of a “helpful nature,” and is synonymous with grace, benevolence, and generosity ¹³ —a broader and deeper realm than compassion. Kind care supports suffering. Kind care also supports such healthcare experiences as shared joy, relief, and exploration.

Infusing the modern healthcare system with trust, safety, and kindness might seem like a formidable task. But all 3 of these essential elements can be taught. Experts have studied all of them, and techniques and training are available.

The healthcare industry and the public health sector have gone through revolutionary changes before. For example, after stringent safety processes were put in place, central line infections—which can be fatal—fell dramatically. ¹⁴ Exposure to lead, ¹⁵ which was once used in household paint, gasoline exhaust, toys, and even in some food products, has plummeted in the United States through concerted efforts and new laws.

A humanism revolution is possible, too. While this will take some effort at the beginning, the momentum is on the side of change. Our healthcare system as it currently stands is not sustainable—it is riddled with problems that are causing an exodus of doctors and nurses, distrust from patients, and financial issues that are closing hospitals across the country.

Once this culture shift is underway, healthcare teams and patients will feel better. That will create momentum. People want to feel the connection and meaning that emerges from a system grounded in humanism.

Kinder, safer, and more trustworthy care will lead to lower emergency room visits, fewer canceled appointments, lower staff turnover, fewer malpractice lawsuits, healthier patients, and healthier healthcare professionals. All of this will benefit the financial bottom line while supporting patients and healthcare teams.

Humanism—clinically excellent care that is kind, safe, and trustworthy—is the catalyst we need to change healthcare.