American College of Chest Physicians (CHEST) launches new health equity initiative based on empathy

A new healthcare initiative has launched in Bexar County, Texas in an effort to improve patient care.

“The First 5 Minutes” focuses on three pillars: enhancing cultural competency by building an understanding of barriers to care, strengthening rapport and trust between clinician and patient, and meaningfully encouraging patients to be active participants in their healthcare and treatment.

The initiative is being launched as an in-person pilot training program in which up to 24 Texas-based clinicians will participate at the University of Texas Health Science Center.

The First 5 Minutes program grew from a five-city listening tour in the Fall of 2020. CHEST hosted virtual calls in areas of the United States, including Bexar County, experiencing disproportionately high incidents of and mortality from COVID-19. The goal of the patient-focused tour was to gain insight and identify solutions to combat health inequities among marginalized communities.

"What we heard was an overwhelming lack of access to healthcare, inequity in treatment, and a dishearteningly low level of trust between patients and their healthcare teams. There are no quick fixes for these deep-rooted issues," said chief executive of the American College of Chest Physicians, Robert Musacchio, PhD in a statement. "However, doing nothing to change this situation and improve patient care is not an option. The First 5 Minutes program is a way we can impact change on a person-to-person level."

Patient participants who were visited during the listening tour expressed the following barriers to trust:

• Perceived dismissive attitudes among physicians
• Lack of understanding and/or appreciation of social determinants of health
• Overuse of highly technical/medical terminology that can be intimidating to patients
• General cultural and philosophical differences that may contribute to implicit biases

As a result, the interactive training model of the First 5 Minutes, led by relationship-centered communication trainers, has the goal of being a nationwide in-person and e-learning program. To improve the participants' empathetic listening, trust-building communication skills are part of the core curriculum, which includes:

• Understanding one's implicit bias and its impact on patient care through small group discussion and activities
• Relationship-centered interviewing and how it positively correlates to patient and clinician outcomes
• Role-playing exercises demonstrating how rapport is established
• Exercises covering the steps of patient- and clinician-centered interviewing

With the aim of strengthening the patient-clinician relationship, the program will provide physicians the tools needed to establish trust and build rapport.

"Every 15 minutes, a medical provider is expected to see another patient. It can be challenging to demonstrate compassion and care in this brief window. Still, it is essential," said Stephanie Levine, MD, FCCP, CHEST past president and member of the program's steering committee in a statement. "The actions and words of the clinician have a tremendous impact on patient care.”