No substitute for good bedside manner

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In this age of rampant and rapidly changing technology, there’s simply no substitute for a doctor with a good bedside manner.

That’s the message from Dr Fiona Kerr, founder and director of the NeuroTech Institute, who has a diverse list of qualifications including cognitive neuroscience, complex systems engineering, anthropology and psychology.

Her work touches on a range of issues, including two transformative practices for medicine - how to  best use  technology, and the often underestimated yet fascinating role of simple, everyday human contact.

“I’ll be talking about the neurophysiology of human interaction and the importance of touch and eye contact when it comes to healing, trust, hope and even patient compliance and medical decision making,” Dr Kerr said.

“For hospital administrators, it’s important to know the science behind your staff interaction with patients. And why the clinicians who have empathy for their patients actually increase that patient’s capability to heal.

“I’ll also be talking about the good use of technology in medicine.”

According to Dr Kerr, balancing the use of tech with human interaction was the key to improved outcomes for patients.

“There is some amazing new technology out there that has the potential to transform medicine, and indeed it already is - it’s phenomenal,” she said.

“But doctors will never be replaced by robots. That human interaction – it’s like a super power that doctors don’t even know they have.

“When we interact face to face, there’s both a chemical reaction and an electrical synchronization in our brains and our bodies. It leads to a blast of chemicals that can change our mood, our health and our stress level.

“It’s something that we can measure – people who are shown empathy and compassion are more likely to get better and make better health decisions, as is the health practitioner.”

Dr Kerr added advances in telehealth and telemedicine had been “amazing” for many Australians, particularly those in rural and remote areas. However, that need for human contact was still there.

“If I’m sitting across from you, face to face, there’s a connection between our neural pathways in the brain and I’m more likely to take on advice you give me – for example about taking medicine, or changing habits,” she said.

“An ongoing personal connection further supports such habit change, and this can be greatly supported by the informed use of tech.

“Giving information through a screen is statistically more easily ignored, and practitioners tend to get a snapshot rather than health changes over time.

“Telehealth for remote areas can work amazingly well and there are some areas where it’s really great, for example group discussions or counselling.

“If I’m having a telehealth consultation with my doctor and I’m on my own, there’s evidence that I would be less likely to tell the doctor about new symptoms I’m experiencing.

 “But if there is a local nurse there, who you know and trust, then all that changes. Direct human engagement plus telehealth, is the best of both worlds for people in those remote areas.”

Dr Kerr said even in our daily lives, direct human contact, particularly eye contact and physical proximity, was vital.

“It’s called retinol eye lock,” she said.

“When we’re nervous or stressed, we look for more prolonged periods into the eyes of someone we trust as a form of reassurance.

“We see it with parents and children, people with their partners – you look them directly in the eye, it increases the connection, boosts oxytocin (for both of you)  and you feel better.

“That works in a health setting too. If I have a nurse who looks me in the eye, maybe takes my pulse with their fingers (thus setting off the c-fibres in my skin through warm touch), or just sits with me for five minutes if I am stressed, that changes everything.

“My cortisol level drops, my adrenaline drops, the level of oxytocin increases which assists my endocrine and immune system, I can better regulate affect and even pain – it changes what’s physiologically happening in my body.”

Dr Kerr is an advisor to the robotics industry, the health sector, the Global Centre for Modern Ageing, Finland's national artificial intelligence program, and defence organisations both in the USA and Australia.

“There’s some fascinating research being done in Finland as to what turns on in the brain when you look directly at a person, as opposed to looking at someone on a screen,” she said.

“There are things in your brain that simply never turn on if you’re looking at someone on a screen.

“It helps if you know them already, but it’s not exactly the same. There is still a lack of direct synchronization that has impacts on various neural areas and the emotional response. In The NeuroTech Institute one of the things we are investigating is how solving a complex problem changes with another human involved as opposed to a neutral screen.”

Dr Kerr added what she was really looking for in her work and her research, was a “quality partnership between tech and humans”.

“For health administrators, it’s about having the information that allows you to think wisely about how to maximise and combine the unique properties of both humans and technology for a result that is truly transformative, yet remains human-centric,” she said.

“And what’s more, it’s often more cost effective.

“At the end of the day, there really is no substitute for a good bedside manner.

In this age of rampant and rapidly changing technology, there’s simply no substitute for a doctor with a good bedside manner.

That’s the message from Dr Fiona Kerr, who will be speaking at the Australian Private Hospitals Association’s upcoming 39th APHA National Congress (APHA Congress).

Dr Kerr, founder and director of the NeuroTech Institute, has a diverse list of qualifications including cognitive neuroscience, complex systems engineering, anthropology and psychology.

Her address at the APHA Congress will touch on a range of issues, including the use of technology in medicine and the importance of simple, everyday human contact.

“I’ll be talking about the neurophysiology of human interaction and the importance of touch and eye contact when it comes to healing,” she said.

“For hospital administrators, it’s important to know how your staff interact with patients. And the clinicians who have empathy for their patients do actually increase that patient’s capability to heal.

“I’ll also be talking about the good use of technology in medicine.”

According to Dr Kerr, balancing the use of tech with human interaction was the key to improved outcomes for patients.

“There is some amazing new technology out there that has the potential to transform medicine, it’s phenomenal,” she said.

“But doctors will never be replaced by robots. That human interaction – it’s like a super power that doctors don’t even know they have.

“When we interact face-to-face, there’s a chemical reaction in our brains and our bodies. It’s a blast of chemicals that can change our mood, our health and our stress levels.

“It’s something that we can measure – people who are shown empathy and compassion are more likely to get better and make better health decisions.”

Dr Kerr added advances in telehealth and telemedicine had been “amazing” for many Australians, particularly those in rural and remote areas. However, that need for human contact was still there.

“If I’m sitting across from you, face-to-face, there’s a connection between our neural pathways in the brain and I’m more likely to take on anything you might tell me – for example about taking medicine, or changing habits,” she said.

“Giving information through a screen, I’m likely to do things a lot slower.

“Telehealth for remote areas can work amazingly well and there are some areas where it’s really great, for example group discussions or counselling.

“If I’m having a telehealth consultation with my doctor and I’m on my own, there’s evidence that I would be less likely to tell the doctor about new symptoms I’m experiencing.

 “But if there is a local nurse there, who you know and trust, then all that changes. Direct human engagement plus telehealth, is the best of both worlds for people in those remote areas.”

Dr Kerr said even in our daily lives, direct human contact, particularly eye contact, was vital.

“It’s called retinol eye lock,” she said.

“When we’re nervous or stressed, we look to someone we trust and we look them in the eye, as a form of reassurance.

“We see it with parents and children, people with their partners – you look them directly in the eye, it increases the connection and you feel better.

“That works in a health setting too. If I have a nurse who looks me in the eye, maybe takes my pulse with their fingers, or just sits with me for five minutes if I am stressed, that really changes everything.

“My cortisol level drops, my adrenaline drops, the level of oxytocin increases – it changes what’s physiologically happening in my body.”

Dr Kerr is an advisor to the robotics industry, the health sector, the Global Centre for Modern Ageing, Finland's national artificial intelligence program, and defence organisations both in the USA and Australia.

“There’s some fascinating research being done in Finland as to what turns on in the brain when you look directly at a person, as opposed to looking at someone on a screen,” she said.

“There are things in your brain that simply never turn on if you’re looking at someone on a screen.

“It helps if you know them already, but it’s not exactly the same. The emotional response is not nearly as good. That physical presence helps with synchronicity.”

Dr Kerr added what she was really looking for in her work and her research, was a “quality partnership between tech and humans”.

 “For health administrators, it’s about thinking wisely and maximising the use of tech while still remaining human-centric,” she said.

“At the end of the day, there really is no substitute for a good bedside manner,” she said.

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