Doctors' Orders: Physicians Urged to Show More Empathy

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Doctors' appointments and hospital stays can be stressful and upsetting experiences. However, they could be made less distressing if doctors expressed more empathy toward patients and their relatives, according to physicians in an editorial in this week's Canadian Medical Association Journal.

Empathy, not sympathy , is the most important emotion for doctors to convey when interacting with their patients, said Dr. Robert Buckman and his colleagues. While sympathy is important, it is empathy the ability to understand and acknowledge another's experience that puts patients most at ease.

"Empathy is the best way to acknowledge what the patient is going through," said Buckman, an oncology professor at the University of Toronto. "Doctors are often thrown in awkward and emotional situations, especially when they have to deliver bad news to the patients. They can help resolve that awkwardness by showing empathy."

An empathic response can be as simple as saying, "I understand this is troubling news for you," Buckman said. Patients often find it comforting when the physician is interested in their general state of mind.

"It's not enough to feel for the patient. It's necessary to go a step further and let them know that you feel for them," he said.

"Studies and anecdotal evidence have shown that patients are more likely to listen to medical advice and stick to the treatment plan if they are treated with empathy," Buckman told MyHealthNewsDaily.

But empathy is surprisingly rare in clinical settings. A 2007 study in the Journal of Clinical Oncology that Buckman cited in his article showed that oncologists responded to patients empathically just 22 percent of the time when they had the opportunity to react empathically. They chose instead to discuss some other aspect of medical care, such as a change in therapy, in 76 percent of these situations.

And a 2009 study in the journal Academic Medicine of 456 medical students showed that their empathy significantly declined during the third year of medical school; ironically, when the curriculum shifted toward patient-care activities.

Other medical professionals agree that this kind of attitude has to change.

Today, there is too much emphasis on doctors delivering care as quickly as possible and discharging patients from the hospital as quickly as they can, said Dr. Maysel Kemp White, of the American Academy on Communication in Healthcare. However, empathy doesn't have to take up more consultation time.

In fact, it can speed up the process, she said.

"Some doctors worry that they'd open a Pandora's box when they ask and acknowledge the patients' emotions . But studies have shown that it's not true empathy actually reduces visit time," White said. "Basically, the patient will drag out a visit with questions if they think you're ignoring their cues and concerns."

Buckman said that instilling empathy in the clinical workplace could be as simple as mentorship of medical students, positive feedback and constructive criticisms among colleagues, and half-day continuing education lessons conducted online.

He also said the value of empathy should be reinforced in medical students as part of their medical school curriculum.

"My hope is that someday, maybe twenty years later, medical students will be examined on empathic responses, just like the way they get examined on biochem or physiology. And if they fail their empathy exam, they'll have to either take remedial empathy courses, or they'll have to settle with being an excellent biochemist," Buckman said.

"The ability to show empathy to your patients is that important to being a good doctor."

Pass it on: Patients are more likely to listen to medical advice and stick to their treatments if their doctor is more empathic. Appointments may actually go faster, too.

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