Well, the same is true when you assess a patient.

Hi, I'm Dr. Cruz.

Early in my career I noticed a pattern with some of my patients.

They often had multiple health issues, were uneasy during office visits, and frequently visited the emergency department.

But worst of all, they never got better despite multiple visits.

Then, I realized something: From an early age, many of my patients were exposed to trauma and adverse childhood experiences or ACEs.

This includes emotional, sexual, or physical abuse, violence, neglect, discrimination, poverty, and other adverse events.

ACEs are more common in the US than you'd think.

In fact, 60 percent of US adults have one ACE, 25 percent have three or more ACEs, and 16 percent have four or more.

ACEs occur in all socio-economic groups but are more common in low-income and minority populations.

For young children, repeated exposure to trauma can impact brain development and literally rewire the brain's response to stress.

So, as they grow up, many struggle with issues related to emotional regulation, like depression, anxiety, or substance use disorders.

Trauma survivors are also more often at risk for chronic diseases, behavioral health problems, and even suicide.

Knowing all this, I began to rethink my approach to care.

Instead of asking patients, "What's wrong with you?" I ask, "What happened to you?"

Recognizing that life experiences are often a root cause of poor health is integral to improving patient care.

Trauma-informed care has helped me take these experiences into account, providing greater insight into my patients needs and how to address them.

Here are five key ways that health care organizations can gradually integrate trauma-informed care into their practices to help patients and staff.

First, build awareness and generate buy-in.

Involve both staff and patients in adopting a trauma-informed approach.

Second, invest in a trauma-informed workforce.

Hire staff that embrace trauma-informed care and provide training not only for clinical staff, but also for non clinical employees like front desk workers or security guards, who are often the face of your organization.

Next, create an environment that is safe and welcoming for patients and staff.

Engage patients in meaningful ways.

Ask how they feel and listen.

You can also build trust by involving them in their own treatment planning.

Finally, identify and treat trauma.

Consider a screening approach that works for your patients, and ensure that treatments and referral sources are available.

These changes take time, but each step improves our ability to connect with and care for patients.

Today, our patients appreciate the changes we've made.

Plus our staff is more in tune with patients, so work is less stressful and more rewarding.

Trauma-informed care.

It can truly transform the caregiving experience from being treaters to being healers.