June 2, 2016

Doctors: How Much Empathy?


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How much empathy should your doctor have?

doctorOn average, doctors interrupt patients within 18 seconds. That may fall short of your expectation but it is average. It is what most people are accepting from doctors. If our expectation is higher if we want real empathy from a doctor, then how much empathy is enough? How much empathy is appropriate?

Some people are satisfied with bedside manner. Bedside manner is assuming the role of kindness for a patient. One doctor described bedside manner as “the ability to comfortably communicate a certain degree of concern about the patient’s welfare.” It is all about the doorknock, the handshake, the eye contact. He goes on to say, “If you have good bedside manner, people will tell you and compliment you on it.” Bedside manner is also defined as the manner or way a doctor or nurse assumes or acts with a patient.

Empathy is understanding and sharing the feelings of another. Feeling versus assuming a role of feeling.

Lastly, there is Sympathy. Sympathy is feeling sorry for the patient.

Patients with empathetic doctors have less pain sensitivity and stress. Additionally, there is evidence that suggests that when our doctors are aware of and acknowledge our needs and concerns with empathy, these doctors do not fall victim to the same levels of burnout, stress, and cynicism as other doctors.

Back to the original question, how much empathy?

As patients become more engaged in their own care they are demanding more empathetic caregivers. Educators in all areas of the medical professions recognize this and are providing continuing education courses such as a course for oncology physicians called Oncotalk. Oncotalk, created by James A. Tulsky, is a model for several courses across the country. (Read the Oncotalk Blog)

“Empathy courses are being added to some medical school curricula to add skills such as self-monitoring by doctors to reduce defensiveness, improve listening skills, and decode facial expressions and body language.” (theatlantic.com)

Also important, the research shows that empathy results in fewer errors and malpractice claims. What doctor wouldn’t love that?

business-gesture-1511534-640x480Why do doctors have trouble with empathy? “Doctors are explainaholics,” says Tulsky, “Our answer to distress is more information, that if a patient just understood it better, they would come around.”

In reality, bombarding a patient with information does little to alleviate the underlying worry.

Healthcare providers tend to distance themselves from patients in certain more high-risk fields to avoid developing attachments to patients that may seriously degrade or ultimately pass away. Doctors lose empathy as a defense mechanism.

Studies show that while doctors do not start out as nonempathic, testing that involves doctors being subjected to images of people being prodded with needles show little ERP or “Emotionally Related Responses.” (http://bit.ly/empathydoctor) It appears that this hypothesis that those in the medical profession develop this lack of empathy may be true.

Empathy comes with a cost.

doctorempathyThere has to be a balance. “The Golden Mean that optimizes care.” The landscape of medicine is evolving in an attempt to keep up with patient demand. As we become more engaged in our care we want our doctors to engage more with us.

According to Scientific American, a study by The Society For Personality and Social Psychology found that “Being too focused on the patient’s pain can make the doctor less effective. Suppressing the response to others’ pain may, in fact, free up information processing resources to more effectively solve clinical problems.”

Finding the doctor that has all of the skills we need takes asking questions. We must begin consulting with doctors on more than our conditions, and talking long enough to understand how a doctor connects emotionally while still remaining objective. We are looking for a skilled physician with empathy, not a best friend.  Find out if your doctor has been trained in continuing empathy courses. Finally, if you feel that you and your doctor are not relating on all of the levels important to you for your condition then it may be time for you to move on.


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Scientific American
The Atlantic
Huffington Post
Art of Patient Care