Saturday, May 12, 2012

Several Recent Articles Stress the Value of Empathy in Medical Care.

The importance of empathy in medical care is the focus of several articles recently published in the medical literature. See below for a brief comment on each and a link or reference to the article.

In an article that appeared in the March, 2012 issue of Perspectives on Psychological Science, Hacque and Waytz include empathy reduction in clinicians as one of the "causes of dehumanization" in medicine. They suggest that clinicians have difficulty being empathic when actively engaged in demanding cognitive processes, such as diagnostic reasoning and problem solving. Empathy reduction can be countered, however, by strategies which promote clinician awareness of the human and emotional aspects of patient care, such as learning about the whole patient (e.g., interests, roles, values, preferences) and recognizing the dehumanizing aspects of medical settings, technology and the procedural elements of care. The article citation is: Hacque, OS, Waytz A. Dehumanization in Medicine: Causes, Solutions, and Functions. Perspectives on Psychological Science vol. 7 no. 2 176-186. doi: 10.1177/1745691611429706                                 

In the May, 2012 issue of the Journal of General Internal Medicine, Helen Reiss and colleagues reported that training in empathy improves physician use of empathic skills. Reiss reports that providing three 60-minute empathy training modules to residents and fellows (physicians undergoing specialty training post medical school) produced significantly greater changes in a patient-rated measure of empathy than residents undergoing standard training. Trained physicians also showed greater changes in their ability to decode facial expressions of emotion. An abstract of the article can be found at: http://www.ncbi.nlm.nih.gov/pubmed/22549298

And, the most inspiring article of the recent articles was written by Bernie Lown, MD's on his personal blog. See: http://bernardlown.wordpress.com/2012/04/29/social-responsibility-of-physicians/ . Bernie is a renowned cardiologist, educator and researcher who has been a proponent of patient-centered care for 60 + years! Dr. Lown is a leading voice in medical ethics and social responsibility and was a recipient of the Nobel Peace Prize for his leadership of the Physicians for Social Responsibility during this organization's campaign to educate the public about the medical consequences of a nuclear catastrophe. He has also been an outspoken critic of overtreatment and
unnecessary use of medical technology, especially in advancing cardiovascular health,  and has emphasized the value of addressing health behaviors and promoting patient engagement and empowerment in his publications. The current article is a transcript of his address to the April, 2012 Avoiding Avoidable Care Conference held in Cambridge, MA. (See http://avoidablecare.org/ for more on the conference). Here is my favorite section:


Sixty years of doctoring has taught me that taking a history, namely listening, is the quintessential part of doctoring. Proper listening is a skill, an art and a core element of medical professionalism. History taking is far more than providing key elements for a diagnosis. It is the basis for nurturing trust. I am persuaded that nothing of science taught to medical students is as difficult to master as is the fine art of listening.


1 comment:

  1. Dr. Riess was interviewed today, May 28th, 2012, by Karen Weintraub, in the Boston Globe.
    See http://bostonglobe.com/lifestyle/health-wellness/2012/05/27/force-interview-helen-riess-doctor-patient-empathy/wKrnttwPk5ZoTGFOEyYjNM/story.html

    A memorable quote: "We’re trying to not have empathy and compassion feel like one extra thing you have to do. One way to actually help you cope . . . is to connect with people and feel this thrill of helping them."

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