December 2024 Pick of the Month

Open Mind, Open Heart 

Some emergency department (ED) workers claim to have the ability to "read minds," often saying: “He’s (or she’s) here all the time, and just wants…” Maybe the mind-reading is right most of the time, but it can sometimes reflect stigma. 

In this month’s POTM, Emergency department staff compassion is associated with lower fear of enacted stigma among patients with opioid use disorder, Steinhauser et al. address this issue. The authors define enacted stigma as “the direct experience of social discrimination and being treated unfairly by others due to identification with a stigmatized group, which results in self-stigma and feelings of shame.” 

The authors appropriately connect higher patient perception of provider compassion with better patient outcomes. While the primary outcome was reduced fear of stigma, the authors suggest that patients treated with compassion will have a greater acceptance of — and adherence to — treatment for addiction. The authors (also appropriately in this article) do not interpret the experience of the compassionate clinicians, though they undoubtably know of the benefit — and perhaps will report those findings separately.

Just reading the title of this paper may relax the knot in your trapezius, as it should. Part of compassion is rejecting the role of mind-reader, alleviating the burden of prejudgment. Erasing prejudgment opens the mind and the heart, allowing us to see patients with addiction as vulnerable. After all, no addicted adult who now frequents the ED ever said as a child: “You know what I’d like to be when I grow up? Addicted to heroin.” 

Jeffrey A. Kline, MD
Wayne State University School of Medicine
Editor-in-Chief

Source: Kirsty Challen, BSc, MBChB, MRes, PhD, Lancashire Teaching Hospitals | AEM Editor of Infographics