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Are Doctors Showing Enough Empathy?

Even some of the most highly trained doctors routinely fail to provide a critical component of care to their patients -- empathy, a new analysis shows.

Jan. 24, 2011 -- Even some of the most highly trained doctors routinely fail to provide a critical component of care to their patients -- empathy, a new analysis shows.

Research suggests that when doctors respond empathetically at appropriate times their patients tend to be happier and more motivated to stay on treatment.

But more often than not, doctors miss opportunities to express empathy in conversations with patients, University of Toronto professor of medicine Robert Buckman, MD, PhD, tells WebMD.

“It may be that there is a fear on the doctor’s part of opening a can of worms,” he says. “They may worry that the patient will start to see them as a therapist and that it takes more time to be empathetic. But the truth is, it takes less time.”

Remaining Detached

Showing empathy does not mean a doctor has to feel what his or her patient is feeling, Buckman says. Rather, it means acknowledging patients’ fears and other emotions.

“It is perfectly OK for the doctor to remain detached, but it is not OK to talk detached,” he says. “Acknowledging what a patient is feeling is not the same as feeling it yourself.”

In a recent study in which oncologists were videotaped talking to their cancer patients, the doctors responded to empathetic opportunities just 22% of the time. More often, the doctors responded by discussing the patient’s clinical care.

In another study involving lung cancer patients, just one in 10 audiotaped patient-doctor exchanges considered to be opportunities for empathy were met with an empathic response.

One exchange highlighted by the researchers:

Patient: “I was doing a man’s labor and I was always told I had a good strong heart and lungs. But the lungs couldn’t withstand all those cigarettes ...”

Doctor: “Yeah.”

Patient: “... asbestos and pollution and secondhand smoke and all these other things, I guess.”

Doctor: “Do you have glaucoma?”

University of Rochester assistant professor of psychiatry and medicine Diane Morse, MD, who led this study, agrees that showing empathy can actually save doctors time and improve patient satisfaction and even outcomes.

“When the physicians in our study made empathic statements, the patient exchanges actually took less time,” she says. “When they didn’t respond empathetically patients were likely to repeatedly raise the point in an effort to get the response.”

Research also suggests that doctors who communicate empathy are less likely to experience professional burnout.

“Physicians who have been trained to do this and who actually do provide more empathy may be better able to care for their patients,” Morse says.

Teaching Empathy

In their newly published analysis, Buckman, University of Toronto colleague Gary Rodin, MD, and James A. Tulsky, MD, of Duke University called on medical schools to place more emphasis on teaching empathic communication.

The three doctors have devoted much of their careers to the subject of improving doctor-patient communication.

“Even though physicians differ in their innate capacities, as with any other skill in medicine, clinical empathy can be taught and acquired,” they write in the latest issue of the Canadian Medical Association Journal.

Buckman says doctors can learn empathic communication skills “in about 15 seconds.”

“When a patient is upset, angry, or feeling some other strong emotion, this should be acknowledged,” he says. “It’s not that complicated.”

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