The expression “It shouldn’t have to happen to you to matter to you” has been making the rounds on social media platforms lately. In my opinion, it’s a great way to define empathy, our ability to imagine ourselves in someone else’s shoes and to take action that would help them. It’s a powerful concept, and it lies at the very heart of what it means to be human.
Empathy Is Critical in the Clinical Setting
In a clinical setting, empathy is critical. An empathetic clinician understands how a diagnosis affects a patient’s mental health and wellbeing. Such a clinician is able to read emotional cues—signs that a patient is being stubborn or resistant or is depressed, for example—that would stand in the way of effective treatment. Empathetic clinicians take these cues into account and become allies of the patient in their health, which leads to better patient outcomes when compared with care provided by non-empathetic clinicians.
There is plenty of evidence to support this. When a physician is empathetic, patients offer more detailed histories, they’re more satisfied with their care, they are more adherent with treatment plans, and they are less likely to sue for malpractice. Empathetic physicians also benefit from better health, wellbeing, and job satisfaction.
Why Is Empathy Hard to Put Into Practice?
If empathy is so important to clinical outcomes, why is it so hard to put into practice? It’s still quite common to hear the old cliché that a certain physician is “a great doctor but has a terrible bedside manner.” There are a lot more of us who are like Dr. House than there are like Marcus Welby, MD, it would seem.
Ananth Ravi, PhD—a radiation oncology medical physicist and Chief Science Officer with MOLLI surgical in Toronto, Ontario—has a few ideas about why that may be the case. He believes it starts with a lack of data.
“Take an area of interest of mine—breast cancer surgery—as an example,” he says. “We have lots of data on surgical outcomes, but when it comes to patient experience, we have much less data. Nevertheless, we know that procedures like wire-guided localization are awful for patients. They’ve told us so, but that’s dismissed as anecdotal. So, we carry on with those procedures over the wishes of the patients, even when better, wire-free alternatives are available.”
There is also a school of thought that a lack of empathy begins in medical school. Various studies have confirmed that by the later years of physician education, student empathy has been eroded significantly. In particular, early clinical experience is singled out as a pivotal point in the erosion of student empathy. The need to defend decisions to attending physicians, for example, can make students more defensive and withdrawn. And a lack of bedside manner can be passed down from generation to generation of physicians through the residency process.
How to Break the Cycle
If that’s the case, how do we break the cycle? How do we ensure that student physicians keep their empathy intact, so that they and their patients can enjoy the proven benefits of empathetic medicine?
“Thinking back to the breast cancer patient example, the most empathetic thing we can do is be advocates for the best, most humane possible care,” says Dr. Ravi. “Rather than subjecting patients to what we know to be less than ideal, we should be advocates for new technologies—like wire-free localization —that are clinically more advantageous and provide a better patient experience. Empathy is more than sympathy, after all; it has to lead to action.”
In terms of educating student physicians, Dr. Ravi has some ideas on that score as well. “We need to be better mentors, and we need to encourage students to seek out better mentors,” he says. “If someone has a reputation for having great clinical skill, we send students to learn from them. Well, if a physician has great emotional intelligence, it should be no different. We need to encourage new doctors to study best empathy practices in the same way that they would study clinical practices.”
When it comes to patient care, we should be prepared to show them that what matters to them, matters to us too.