Caring – Still Job One

The legendary news journalist Walter Cronkite once described the healthcare system in America as "neither healthy, caring, nor a system.” Not caring? Is it possible that the word used to describe the essential job of all caregivers has lost its meaning?

The Arnold P. Gold Foundation defines humanism in medicine by the acronym, "I.E., C.A.R.E.S.” – which stands for Integrity, Excellence, Compassion, Altruism, Respect, Empathy and Service.1 The art and science of caring requires demonstrating these humanistic attributes while attending to the technical aspects of history taking, examination, diagnosis, treatment, and follow-up.

Caring can be demonstrated by anyone and should be practiced by everyone who has patient contact – doctors, nurses, and medical technicians as well as gift shop, office, and lunchroom staff. Care is the intent, the inertia, and the cornerstone of the patient relationship. From the very beginning of the patient interaction, throughout treatment, and long after healing, health care (two words) has the power to transform a closed and limited system to an open and inexhaustible system of healthcare (one word).

The business of healthcare is so busy and complicated that it may be hard for caregivers to find the time and the energy to care for their patients. This faux pas will change only when caring is recognized as a crucial part of improving clinical outcome and patient satisfaction. Indeed, the lack of caring contributes to medical mistakes, negligence, malpractice, unprofessional behavior, and overt insensitivity to patient well-being. News reports, patient experiences, and personal observations of unprofessional attitudes and behaviors suggest that some caregivers forgot why they got into healthcare in the first place. In fact, academic research studies suggest that caring (in particular, those attitudes and behaviors that reflect empathy and compassion), may actually diminish during medical training.2

Even though the desire to devote one’s life to caring for others may have been the initial motivation for pursuing a career in the health professions, caring attitudes and behaviors are experience-dependent and must be coached and nurtured. Without modeling, encouragement, and practice, critical reasons for caring may be forgotten and displaced by conflicting interests. But the power of caring should not be underestimated – both in terms of improving clinical outcomes and renewing a sense of meaning and purpose in the caregiver’s own life.

There really is no better place to be than where one is needed. Caregivers are privileged to have the implicit trust of their patients, along with society’s high esteem and material rewards. By neglecting to remind students and practitioners why they got into healthcare in the first place (i.e., to care) medical educators, employers, and colleagues miss golden opportunities to influence lifelong attitudes and behaviors that have direct impact on patient relationships, medical outcomes, and personal satisfaction.


  1. What is humanism in medicine? The Arthur P. Gold Foundation; 2013. Available from http://www.humanism-in-medicine.org/
  2. Papadakis M, Hodgson CS, Teherani A, Kohatsu ND. Unprofessional behavior in medical school associated with subsequent disciplinary action by a state medical board. Academic Medicine. 2004;79(3): 244 – 249.


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