Empathy In Medicine

“Room 305 is in pain.”

“Appendicitis is complaining of nausea.”

These sentences, and a lot of similar ones, are heard on a daily basis in hospital wards. Many doctors, nurses, and medical students tend to communicate that way. It may seem dehumanizing for you. If you were once a patient, you must be thinking that this is unacceptable, being called by your room name! If you were a doctor or a healthcare professional, you may think: “I would never do that. This is unacceptable!” Yet, a lot of time, even the best of us can do this. Why? Does this behavior show a lack of empathy?

Generalities about empathy

Empathy is defined as “understanding another person’s experience by imagining oneself in that other person’s situation: one understands the other person’s experience as if it were being experienced by the self, but without the self actually experiencing it”, according to Hodges and Myers in the Encyclopedia of Social Psychology.

It is important to note that empathy is not synonymous with sympathy. Sympathy is directed towards a situation, while empathy’s core is the feeling. For example, if you encounter a homeless person and think “I am sorry for the way they are living”, this is sympathy. In contrast, if you understand that this homeless person is feeling lost and lonely, and you can feel their emotions, you’re being empathetic.

Is empathy innate or acquired?

Actually, it is both. On one hand, research into the concept of empathy led to the discovery of genetic material encoding our ability to empathize. Another research added that individuals on the autism spectrum have lower empathy levels. On the other hand, studies looking at differences of empathy levels between individuals found that the levels of empathy varied between both sexes. Indeed, women tend to be more empathetic due to non-genetic cultural factors such as socialization and education, or non-genetic biological factors such as hormonal influences. 

Empathy was also found to be a learned behavior. In a study that followed children educated on how to express their own emotions and understand what they feel, it was concluded that these kids were more “emotionally intelligent” and had higher levels of empathy. To simplify it, if you learn how to embrace your own emotions and label them, you will learn how to become more empathetic. Thus, there is no such thing as “I do not feel empathy”.

Clinical empathy

This term is defined as:

“The distilling or connecting of feelings and meanings that are associated with a patient’s experience while simultaneously identifying, isolating, and withholding one’s own reactions.”

In other words, the only difference between feeling empathy in general and clinical empathy, is that, in the latter, you do not express your own feelings. It is all patient centered!

Why is clinical empathy important?

Researchers found that patients treated by physicians having high empathy levels were more likely to stick to the treatment plan, abide by the doctor’s instruction, and take their medication on time. This all led to better patient outcomes. Furthermore, the data showed that these patients had higher satisfaction and trust levels, lower complications rates, and were less likely to file a lawsuit against their physicians. Therefore, all the previously presented discussion and understanding of clinical empathy is of utmost importance.

“Empathy requires being attuned to the patient’s perspective and understanding how the illness is woven into this person’s life. Last–and this is where doctors often stumble–empathy requires being able to communicate all of this to the patient.” Danielle Ofri, What Doctors Feel: How Emotions Affect the Practice of Medicine

Clinical empathy and medical education

Although the importance of clinical empathy was highlighted by many researchers, Moudatsou, M. et al. concluded that empathy levels were decreasing among medical students in all their undergrad, grad, and post grad years. This finding was really expected especially after studying the medical schools’ curricula. According to Majumder, A. et al. (2020), the “old school” medical teaching methods were the essential reason behind this decline. Medical students learn in a didactic, competition-based environment. They are taught about diseases and treatments but never about “the humanitarian” approach to patients. They learn how to cure illnesses, but never how to treat human beings. In addition to this gap in education, the learning conditions such as long working hours, huge load of patients, tremendous amount of paperwork, leave the students in challenging situations that enable them to work on their emotional intelligence. The latter, as previously discussed, is a cornerstone for clinical empathy.

On the other hand, research showed that you can actually teach empathy. As weird as this may sound, the integration of systematic training of humanistic qualities into medical school curricula will create more empathetic physicians. The systematic training includes narrative medicine and artistic activities (drama, dancing, narrative journaling, museum visits…). Thus, advocacy for a change in the medical schools’ curriculum, especially after knowing the importance of clinical empathy, should start as soon as possible.

What can students do?

As medical students or physician residents, you have a lot to worry about: exams, studies, your patients, etc. Yet, I am sorry to tell you that you also must worry about clinical empathy. I am not suggesting that you change the whole medical curriculum; rather, you can start by changing your lifestyle. You cannot pour from an empty cup: therefore, starting to take care of your mental health and being more aware of your own emotions is the best way to start.

What you can do is take good care of your mental health, by acknowledging your own feelings and learning how to label them. When tired, take the rest you need, do not overwhelm yourself. Respect your body, eat, sleep, and exercise regularly. On a final note, you can always reach out for support, from family, friends, and you can always reach out to us at LAMSA.