Should a doctor display clinical empathy; how does it help the patient?

M3 India Newsdesk Aug 16, 2019

When it comes to talking to a patient, many of you may have experienced a conflict between talking as a professional and expressing empathy at the same time, sounding like a friend. You may have done either but what should you really have done?

Would expressing empathy take away the professionalism that you are supposed to maintain or would it not matter till the time it’s serving the patient well?

We try to get answers to your dilemma through this write-up. But first let us get the meaning right – what is empathy? It is understanding what a person is going through. However, in medical parlance, empathy is referred to as Clinical Empathy.

What is Clinical Empathy?

Clinical empathy goes on to include the act of spelling out the patient’s feelings of fear, anxiety or doubts pertaining to his or her disease, the condition and the prescribed treatment options.

A 2018 article titled 'Focus on clinical empathy in medical studies' by Jaury P., Buffel du Vaure C. and Maury A., presents the concept of Clinical Empathy as three aspects combined for a therapeutic relation between a physician and a patient.[1] Here’s how we interpreted it:

  1. It involves the physician’s understanding basis his observation and imagination (of the patient’s condition)
  2. It perceives care as an ethical value, with environmentally and professionally appropriate expression of care and warmth, and
  3. It involves the ability of the physician to control his or her emotions, distinguish between the emotions of the patient and his own, and the ability to move on.

The same article also reminds us of one of the definitions of empathy as presented by C. Rogers in A Way of Being, which when simply put, translates to: to accurately get into the frame of reference of another ‘as if’ you were experiencing that. In absence of the ‘as if’ bit, a physician loses his own state of emotional balance and starts identifying with the patient.

How empathy helps a patient

The act of empathising in a clinical set up can mean validation of what the patient is really feeling. Acknowledgement of the same can help the patient calm down a little when he or she realises that the physician understands the problem and the related pain and worries. This can also boost the patient’s confidence in the doctor, making him or her more receptive of the doctor’s advice and treatment. Chances and speed of recovery may also increase.

Clinical empathy linked to patient satisfaction

Paper 195 by Menendez M., Chen N. C., Mudgal C.S., et al., based on the 2016 annual meeting of the American Academy of Orthopaedic Surgeons, provides insights on clinical empathy through a trial with over 100 patients.[2] Although the research was limited to the surgeons conducting hand surgery, the paper raises points that seem relevant to many departments of medicine.

The research is conducted to question if a hand surgeon, as an empathy provider, can influence patient satisfaction in a specialty clinic and a highly technical department, such as hand surgery. The findings state the importance of effective interpersonal communication skills. And that making the patient feel heard and cared for in such set-ups is far more important than providing medical advice.

The paper concludes that patient satisfaction plays a vital role in reimbursements, hence, specialized educational programs should consider training students of hand surgery in empathic communication skills. Needless to say, this is a pertinent recommendation, applicable to most medical fields today.

To empathise or not to?

Given the commercialisation of medical services, it is important to know how patients feel while coming to you for treatment or using any clinical service. Being able to understand a patient’s feelings only adds a human touch to your treatment; and that is something every patient would appreciate. Also, chances are the patient will trust you more and adhere to the prescription. This can especially be useful in cases of patients with mental health issues, elderly patients and patients who have given up hope while coping with life-threatening diseases.

However, as a physician, it is extremely important that you do not start either projecting your anxiety about the treatment or engage with the patient’s feeling and suffering. This is where you need to strike a balance between ‘feeling for another’ and ‘getting emotionally involved in the feelings of another’. Your involvement in the patient’s suffering should be limited to your medical understanding of what he or she would be experiencing. There is no place for any assumptions, your emotions pertaining to the patient or the disease, or your own worry about the success of your treatment.

To conclude, it is important that you empathise for the sake of providing a human touch to healthcare, for improved patient satisfaction and the associated advantages. But while doing so, ensure you do not lose the objectivity of it all or as C. Rogers intended to explain, without losing the ‘as if’ quality about the patient’s frame of reference.

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