Wednesday, September 24, 2008

Empathy in physicians

This study, published today, about physicians missing opportunities for empathy, made me chuckle (okay, and kind of roll my eyes too). This specific study looked at patients with lung cancer and doctors' empathy to their concerns about mortality and treatment options.

The study defined empathy as, "
the identification with and understanding of another person's situation and feelings (and) is considered an important element of communication between patients and physicians and is associated with improved patient satisfaction and compliance with recommended treatment."

The results from the study showed that of 384 "empathic" moments, doctors were only empathic 39 times, a mere10%.

Here is one example of where a doctor missed using empathy skills:

Patient: I don't know what the average person does in just two year, three years, a year?

Physician: I think that . . . you certainly could live two or three years. I think it would be very unlikely . . . But I would say that an average figure would be several months to a year to a little bit more.

Though this study was small, consisting of 20 recorded and transcribed consultations, this is likely a scenario carried often. I bring this up, because I'm sure we have all run into a doctor or two who just did not have empathy skills and seemed to not care about our concerns. Some doctors are completely ignorant and make stupid remarks, but they're in a completely different category. For the most part, I've been pretty lucky to have physicians be concerned about me, but I've definitely had those that had horrible bedside manners, were completely ignorant, or didn't listen at all. They don't make you feel entirely secure about the medical profession as a whole. (but of course, there are those standouts that make a difference too)

The thing is, even with the hassles of insurance and time constraints, it doesn't take a doctor or anyone alike long to make a simple remark of concern about you, the patient. Sometimes, it's just comforting to know they are listening and for maybe a moment can feel what it is like to be in your shoes.

In another recent commentary in JAMA, there is a suggestion for training young doctors to have more emotional intelligence, the abilities to perceive, use, understand and manage emotions. While some doctors don't agree with the value of emotional intelligence, other research has showed its effectiveness in improving empathy skills among medical students.

In the end, whether it is a physician or another professional, communication skills are important for you to receive the appropriate care and treatment. This includes both the textbook knowledge as well as understanding emotions and empathy. A dose of concern certainly helps and can go a long way.


Cammy said...

My works at a women's crisis center, and her main job is traveling around giving seminars to schools, businesses, churches, etc, on domestic and sexual violence. Just yesterday she talked to a class at a medical school, and afterwards she got to watch on a hidden camera while they did role-play exercises simulating domestic violence patients in an ER. She said she was shocked at how cold and simply incredulous they were about the seriousness of domestic violence, even AFTER her lecture. Can you imagine how terrible it would be for a battered woman to be seen by a doctor like that when she finally worked up the courage to reach out? I think that psychology and other subjects relating to PEOPLE, not just bodies, should be required to earn an M.D.

Tiptoe said...

Cammy, I couldn't agree with you more. Maybe part of the reason why doctors become so "emotionally" deflated is due to how they are taught in medical school, especially with gross anatomy. Many times, they're taught to disconnect with their mind. I think Pauline Chen talks about this in her book, Final Exam, which I haven't read yet.

As for the students who were observed, that is just awful. Women who have gone through domestic abuse should not have to worry about how their doctor is going to treat them. Maybe they need to watch more of Olivia Benson on Law & Order SVU. ;-)

KC Elaine said...

I think it's a great idea to teach doctors about emotional intelligence. I certainly preferred my doctor who was more empathic and understanding to the brisk, professional sort.

Tiptoe said...

Kyla, I definitely hear you on that. To have just an ounce of empathy really goes a long way.