HELPING DOCTORS DEVELOP COOL HEADS AND WARM HEARTS

What does it mean to be a modern physician? That’s one of the many questions that Professor Kiki Lombarts has posed after a 25-year career in the development of doctors and medical workers. Today, she is Professor of Professional Performance and the chair of Amsterdam UMC’s Professional Performance & Compassionate Care (PP & CC). She leads a research group that studies the functioning and performance of doctors, using evidence-based tools for performance evaluation.?

Since 2019,?Esperto has had the privilege of collaborating closely with Prof. Lombarts in developing assessments that put their research into practice. Our partnership with them was manifested in Perito Professional Performance: a digital platform that provides questionnaires and insights for medical specialists to continue their professional development. Guided by Prof. Lombarts’ pioneering work, Perito helps facilitate further reflection, conversation and change for medical professionals.

“Everything we offer in the Perito environment is the result of research,” says Prof. Lombarts. “So, doctors really know, whenever they go to Perito with whatever part of performance they want to get measured, that it is evidence-based, it’s of high quality. We show them what the psychometric qualities are of every questionnaire tool we develop.”?

The spectrum of topics that Perito addresses includes medical learning climates, patient care, team and group dynamics, and physician’s vitality and well-being. Assessment tools help doctors collect information about their performance, and in-depth reports generated by those assessments reveal insights about their improvement and pave the way towards meaningful reflection.?

Perito works from a programmatic perspective that promotes the use of multiple assessments to give physicians lots of data points in terms of performance. It’s part of the role of the modern physician.?

“Doctors have to perform as individual caregivers, but they also play a role of supervisor in teaching clinics, and sometimes program director; they have to be, or are, members of care teams; and they’re also members of teaching groups. So, there's all kinds of performance domains,” says Prof. Lombarts. “We try to develop different tools that give them information about a certain role or a certain domain that they’re performing in.”

Altogether, Perito operates broadly from a philosophy that Prof. Lombarts founded in 2014: that today’s doctors should have cool heads and warm hearts.

The Pillars of Professional Performance

Prof. Lombarts recalls identifying her signature philosophy when she was preparing an inaugural speech as Professor of Professional Performance. It emerged during reflection of the many years she’s spent working with, collaborating with and observing doctors and their professional development. She considered how physicians have a huge responsibility in caring for patients who are in vulnerable positions. There are ways to identify strengths, but there are still many ways in which healthcare fails patients.?

In 2014 (with updates in 2016 and 2019), she published?Physicians’ Professional Performance: Between Time and Technology?— an inspiring plea for doctors with cool heads and warm hearts. The text details three pillars of professional performance, identified by Prof. Lombarts, that reflect a shared ideal among doctors: the constant pursuit of excellence, humanistic practice, and accountability of one’s own actions. By nature of their profession, doctors seem to approach excellence rather organically, but investigating further the aspect of humanistic practice — of working with patients through compassion and empathy — was something that doctors were keenly interested in.?

There’s a lot of new focus on constantly improving, on rankings, on numbers, on targets, etc. What doctors felt was missing is time to really connect with the patient as a human being.

She explains, “There’s a lot of new focus on constantly improving, on rankings, on numbers, on targets, etc. What doctors felt was missing is time to really connect with the patient as a human being. The heart part, the?heartfelt?part, the human-to-human connection. With patients but also with colleagues and even with themselves.”

Prof. Lombarts describes that many physicians today feel as if they are trained “almost like robots.” They’ve been equipped with a wealth of scientific and medical expertise, but their training lacks the significance of compassionate interactions with patients.?

“Their aspirations, their motivation to go into medicine, often are to help people,” Prof. Lombarts says of doctors. “For many of them, there’s a feeling of, ‘I want to serve and I want to help patients.’ But they end up spending two days a week in administration, doing a lot of managerial work that they don’t have training for, and that does not contribute to their professional fulfillment. They think, ‘This is not what I signed up for when I started my medical training.’”?

Prof. Lombarts says that compassion is an essential tool doctors need (and want) to master for the quality of care they provide.?

“What we’ve seen now, thanks to all the research that has been done in this field and that we’re doing ourselves, compassion is as much a science as it is an art. Meaning, if we could include the science of compassion in the science of medicine, it would be easier to teach it. Currently, there’s hardly any place in the curriculum to talk about the science of compassion. We know that it?really?matters if you make a connection to the patient. You can ultimately see it in clinical and patient outcomes,” says Prof. Lombarts.?

She explains that evidence shows how compassion contributes positively to patients’ trust in their doctors, feelings of being seen and heard, and better compliance with treatment plans. At the same time, doctors’ overall vitality and well-being improve, and healthcare costs may be positively impacted as well. This scientific proof suggests that compassion is not ‘an extra’ or ‘add-on’ — it’s essential to being a doctor today.?

Developing Assessments With Compassion in Mind

The science of compassion and the three pillars of professional performance of excellence, humanism and accountability are central to Perito’s work. These guiding principles illuminate the path towards creating evidence-based assessment tools that support the development of doctors with cool heads and warm hearts. Prof. Lombarts’ team of researchers, doctoral students and PhD candidates develop the content of each assessment, and Esperto creates the technical platform that makes feedback actionable and insightful.?

"We’re always, always thinking about new tools. There’s always always something that we can propose, a specific compassion tool may be one of the next ones."

“It’s a journey that you’re walking together,” Prof. Lombarts says of this type of partnership. “I really appreciate how we’re collaborating with Esperto. I think these things can only be successful if both parties are in it equally, and we really need it when working with this platform. I value their experience and their service orientation.”?

Currently, there are seven assessment tools available for physicians to utilize on the Perito platform. But there are many different topics that Prof. Lombarts would like to focus on while developing new tools: patient safety culture, multisource feedback for residents, psychological safety, social cohesion and, of course, compassion.?

“We’re always, always thinking about new tools. There’s always always something that we can propose,” says Prof. Lombarts. “A specific compassion tool may be one of the next ones. I think that’s very interesting, and for us, it’s a way to push the topic into healthcare a little bit further.”?