Closing the empathy gap in health care: Connection First - before "intake".

In this article, a communication framework of Connection First is presented to close the empathy gap in mainstream health care, including palliative and end-of-life care. Expanding beyond biomedicine, Connection First involves rethinking and restructuring business-as-usual in health care. It shifts the typical transactional process during the initial intake session into one that is transformational. Connection First is a structural intervention and skillset comprised the following elements: disrupting diagnosis, humanizing history, and repairing ruptures. These elements combine to close the empathy gap in health care during the initial clinical encounter, before intake, and improve outcomes.