The importance of ritual in transforming healthcare


(originally published by FierceHealthcare‘s Hospital Impact)

“Dad, why is it that we so love going to Starbucks together?”

It was after our workout. We had just pushed one another beyond what we are typically capable of. And now, together, we journeyed to Starbucks. We left the warmth of our car. We discussed what delicacy we would be ordering (Grande Flat White Breves). We placed our order with the smiling barista. We awaited the creations while smelling the amazing aromas. We discussed our workout and life. And then with great anticipation we received our Breves with another smile.

“T (short for Tommy Jr.), I believe beyond the … (and I described what I noted above) … it is the ritual of the visit,” I told my son. “It is us bonding together in something we both enjoy, it is the opportunity for us to take a breath and focus on our relationship and the love we share as father and son and doing so as we ‘break bread,’ and it is us doing so while joining in community with others. It is this ritual I believe that enhances the experience and creates the specialness of going to Starbucks … together.”

And as I was sharing my thoughts I recalled–and understood that my response to my son was inspired by–the amazing TED Talk by Dr. Abraham Verghese, “A Doctor’s Touch,” in which he brilliantly discusses the importance of ritual in the healing encounter.

And I began my ritual. I always begin with the pulse, then I examine the hands, then I look at the nail beds, then I slide my hand up to the epitrochlear node, and I was into my ritual. And when my ritual began, this very voluble patient began to quiet down. And I remember having a very eerie sense that the patient and I had slipped back into a primitive ritual in which I had a role and the patient had a role. And when I was done, the patient said to me with some awe, ‘I have never been examined like this before.’ Now if that were true, it’s a true condemnation of our health care system, because they had been seen in other places.

And this memory of Verghese’s ritual discussion prompts me to write today.

There are amazing, caring clinicians throughout the healthcare system, i.e., physicians, nurses, therapists and so many others. And yet as healthcare leaders we do not position them or their patients for optimal healing. Rather we continue to create “caring” models that are essentially antithetical to true caring.

Our physicians are burning out (and worse). Our nurses are burning out. Fewer and fewer physicians are choosing to become primary care physicians. And we wonder why?

We healthcare leaders must do better. We must create and improve systems to position these amazing clinicians to re-engage with the reasons they became healers in the first place (their WHY). We need to create healthCARING models that allow for ample time and continuity for clinicians and their patients to develop relationships, for authentic human connection to be achieved, for trust to grow, for whole stories to be told and truly heard, and for co-created individualized care pathways to be made.

And we need to bring ritual back into healing. Listen to Verghese’s TED Talk. And note that ” … rituals are all about transformation.” And further, ” … if you shortchange that ritual you have bypassed on the opportunity to seal the patient-physician relationship.”

So let’s transform healthcare. Let’s create healthCARING. Let’s go back to the Hippocratic Oath

I will remember that there is art to medicine as well as science, and that warmth, sympathy and understanding may outweigh the surgeon’s knife or the chemist’s drug.

Let’s bring ritual back into healing, and let’s seal the physician-patient relationship.

It is not too late and yet long overdue.


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