Contemporary physicians face tremendous pressures due to a confluence of factors, including balancing heavy patient loads within constrained schedules, the increasing complexity of patient health problems, and increasingly burdensome COVID-related documentation requirements.
These circumstances—and more—challenge physician empathy, and even to some extent dampen it down even further. Multiple research studies document a decline in empathy that appears to begin in the third year of medical school and persists during residency.2,3 The pandemic has exacerbated this deterioration. In the past, empathy rebounded after the rigors of training were over, but today, empathy needs to be refreshed to help both patients and providers. Physicians who lose sight of the meaning, purpose, and rewards of their roles in
patients’ lives suffer more from burnout than those who remain connected to their purpose.
The role of empathy training
In response to patients’ pleas for more empathic care and national media headlines calling for more compassion in medicine, which have been growing since about 2005, empathy training courses grounded in the neuroscience of emotions and emotional intelligence can be helpful.
In fact, recent neuroscience research on the brain’s plasticity in up-regulating and down-regulating empathy provided evidence that empathy could be taught.
The research team in the Empathy and Relational Science program at Massachusetts General conducted a study of the effectiveness of the three, 60-minute empathy training courses in physicians.4 Researchers found statistically significant improvement in patient perception of physician empathy on a validated and reliable empathy rating scale called the “CARE measure.” Another study by the same team shows that empathic physician behaviors resulted in higher ratings of both physician warmth and competence.
One of the most frequently asked questions about empathy training is, “Doesn’t this just add even more time to a busy doctor’s day?” Actually, it does not. Empathic care does not have to take more time. Courses on empathy training help healthcare professionals pick up on
subtle emotional cues and nuances that indicate patient concerns so they can be addressed right away.
In addition, when physicians convey empathy, they put patients at ease, increasing trust in the provider-patient relationship. This creates a dynamic that ensures that small problems are addressed before they become bigger problems. Multiple studies have demonstrated that better
medical outcomes are also correlated with strong empathic and relational skills.
Empathy training offers many benefits
Courses based on Empathetics research and principles provide training for each of the following predictors of risk of increasing medical professional liability claims:
1. Physicians’ uncaring attitudes, attitudes of superiority, or callousness
2. Communication failures including not listening, interrupting, or not being clear about availability or backup coverage
3. Disparagement of previous care
4. Failure to learn and manage patient expectations
Physicians engaging with empathy courses learn how to perceive patient emotions, manage difficult interactions, and communicate bad news. Courses provide education that shows physicians how to respond with empathy and compassion even in challenging situations, including informed consent conversations and inter-team conflicts.
In addition to greater patient satisfaction, doctors also discover the personal satisfaction that connecting with their patients in a more meaningful way provides. “After empathy training, I feel that I like my work again, and instead of resenting all the demands, I’m remembering why I chose this profession in the first place,” a physician reported.
Interviews and research around Empathetics and empathy-based practices reveal that greater empathy not only improves patient satisfaction, but also helps to reduce physician burnout and improve physician job satisfaction. By using empathy-based skills, physicians, nurses, and other providers become more attuned to the needs of patients and their families. With this greater perception and shifts in attitudes, communication between providers and patients improves.
More empathic conversations will enable patients to trust their care to physicians who are confident in their skills without demeaning prior care they may have received. Patients will appreciate physicians who take the time to explain things clearly, ask about and understand
their expectations, and form alignment about what is desired, likely, and possible.
Empathy-based training brings rewards
Through empathy-based training, physicians and other healthcare providers learn the skills to have honest informed consent discussions without causing undo fear, while also preparing patients for all possible outcomes. Empathic skills make for better physicians, better communications, and better conversations for all outcomes.
With a strong alliance between patients, patients’ families and physicians, a reduction in medical professional liability claims is the result of increased trust, better understanding and expectations of all possible outcomes, and knowledge that physicians deeply care about their patients, because, when it comes to healthcare, empathy matters.
References
1. “’Death by 1000 Cuts’: Medscape National Physician Burnout & Suicide Report
2021,” Medscape.com, Jan. 27, 2021, https://www.medscape.com/slideshow/
2021-lifestyle-burnout-6013456#1.
2. “Does Empathy Decline in the Clinical Phase of Medical Education? A Nationwide, Multi-Institutional, Cross-Sectional Study of Students at DO Granting Medical Schools,” Academic Medicine: The Journal of the Association of American Medical Colleges, June 2020, https://journals.lww.com/academicmedicine/fulltext/2020/06000/does_empathy_decline_in_the_clinical_phase_of.39.aspx.
3. “The Devil is in the Third Year: A Longitudinal Study of Erosion of Empathy in Medical School,” Academic Medicine: The Journal of the AAMC,” Oct. 2009, https://www.researchgate.net/publication/26767120_The_Devil_is_in_the_Third_
Year_A_Longitudinal_Study_of_Erosion_of_Empathy_in_Medical_School.
4. “Empathy training for resident physicians: a randomized controlled trial of a neuroscience-
informed curriculum,” U.S. National Institutes of Health National Library