Doctors need empathy

Empathy in clinical practice is an essential component of the doctor-patient relationship. This is the understanding of how another human being is feeling without going through the emotional rollercoaster yourself.  Unfortunately, however, it is often lacking. Indeed, studies of medical undergraduate education reveal some evidence that there is a decline in empathy as students move through their training. This could be because the message that predominates now seems to be that doctors and healthcare professionals need to be detached if they want to remain professional. I think this is totally wrong and leads to poor patient experience as well as less effective doctors.

I believe that developing a broader skill of empathy for medical students is essential and it is a more realistic goal than urging them to be sympathetic or compassionate – which can be emotionally draining and even lead to clinician burnout. It is possible to teach empathy in medical school, if students are given the appropriate support and regulatory structures to follow as guides to best practice.

Empathy starts with curiosity and imagination. Doctors need to imagine being the patient undergoing the patient’s experience rather than imagining themselves undergoing the patient’s experience. The more sophisticated approach requires mental flexibility, an ability to regulate one’s emotions and to suppress one’s own perspective in the patient’s interests.

The context is very important obviously, and empathy is not something you can jam into a 6 minutes doctor’s appointment. It needs time to be effective.

As a former practising GP, I am convinced that family doctors struggle to maintain feelings of empathy towards patients not because they don’t want to, but because they don’t have enough time to engage with patients in any meaningful way. Instead, they have to be focused on measurements of efficiency and targets.

Those that do manage to find the time to use empathy as a valuable tool must also be supported. Empathy is still emotionally challenging and can overload a busy doctor. Peer to peer support is one way to ensure that doctors feel that they can offload worries or extra strain. I also think that supported supervision should be available to doctors as a matter of course, as it already is to psychologists and nurses. This kind of overview, with timely interventions when needed, is extremely helpful. Doctors should also be able to reach out to mentors on a formal or informal basis.

If we don’t take steps to address the empathy deficit, then the problem will only get worse as we face challenges like the ageing population. More elderly people who may have difficulties including dementia, will need the kind of understanding that comes with empathy. Empathy, unlike syrupy compassion, is also an active word which implies action. It is not enough to be concerned for someone – you also have to do something to make a difference and improve the outcome.

 

The full article ran in the Journal of the Royal Society of Medicine

Dr David Jeffrey

Dr David Jeffrey is an honorary lecturer in palliative medicine at the Centre for Population Health Sciences in Edinburgh.

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