How Do You Really Feel?

This question may feel more appropriate for a therapy session than an annual check-up, but taking time to consider all that it means can improve the healthcare provider-user relationship on both sides.

Lists of suggested books for medical students consistently focus not on human anatomy or how to ace exams but on emotional, intimate looks at illness, mortality, and the meaning of life. Why do so many who have put in the hours of studying and surgery performing recommend books that are only medically adjacent? It may have something to do with the growing importance of empathy in medicine. Healthcare professions naturally attract helpers, people that want to serve others. Unfortunately, sometimes somewhere between the long hours, overcrowded waiting rooms, and mountains of paperwork, that message gets lost creating distance between patient and provider. But research suggests practicing empathy may hold the key to narrowing the gap. 

Empathy, as defined by an article in the National Center for Biotechnology Information (NCBI), is “the ability to understand and share other people’s feelings.” It has cognitive, affective, and behavioral aspects. Cognitive describes the ability to objectively understand others’ situations and see from their point of view. Affective refers to the unconditional acceptance of the other person. And actions aimed at solving problems or relieving pain fall under behavioral. 

This may seem like a lot, but when put in everyday terms, it becomes much simpler. Two friends are talking on the phone. Friend One recently experienced a stressful incident at work- a meeting got moved forward, so they had less time to prepare. Friend Two draws on a similar experience recalling the events and their feelings at the time to help them relate. They encourage Friend One to share openly without questioning or discouraging them. After Friend One finishes their story, Friend Two offers words of encouragement. These types of empathetic interactions happen daily without much thought into the science behind them. 

However, even healthcare professionals that practice empathy with friends and family may struggle to transfer behaviors to their work environments. Studies show that many, as high as 70%, do not know how or find it difficult to connect to users on an emotional level. Even for those that do, this ability gets lost over time. Medical students’ empathy increased during their first year of school but decreased by their third and stayed low through graduation. Professionals cite busy schedules and lack of training as factors negatively impacting their ability to practice empathy. An article in the AMA Journal of Ethics suggested it may also be caused in part by the “clinically detached” physician model recommended in older research and schooling. The argument being that emotions cloud a physician’s judgment leading to poor patient treatment. However, more research now disproves this. 

Practicing empathy results in positive, measurable outcomes. It opens lines of communication, empowering patients to share more about their concerns, medical histories, and other factors that may provide insight into their health. Patients are more likely to participate in crafting and following treatment plans and trust their providers. One study of cancer patients found an empathetic approach resulted in lower levels of stress, depression, and aggressiveness. This extends through all aspects of the healthcare industry. Having an empathetic approach to handling a billing or insurance question makes a stressful or confusing time easier resulting in higher patient satisfaction. In turn, these boost the company’s reputation. By taking care of patients’ emotional and physical health, users rate the entire experience more positively. Additionally, empathy in healthcare benefits professionals. Those that practice empathy report lower levels of burnout and depression.    

In his article on empathy in medicine, Dr. Elliot M. Hirsch recalled role-playing and writing reflections as part of the empathy training he received in medical school. He went on to say that many of his fellow students did not take the lessons seriously, viewing them as a waste of time, time better spent studying. The culture in medicine and medical school dictates that softer skills, like emotional intelligence, communication, and listening, are either not necessary or less valuable than quantifiable subjects. These barriers to practicing empathy point to larger issues within healthcare systems, like limited education and resources. 

To remedy this, institutions can encourage and incentivize treating patients empathetically. When systems reward treating patients quickly or focus on treating symptoms rather than root causes, practitioners receive the message that empathetic behaviors are not valuable and will not lead to success. While reforming entire systems can’t happen overnight, individuals within healthcare can take steps to ensure they improve institutions through their contributions. 

For some, practicing empathy comes naturally. But for those wishing to improve their skills, education is key. It can take many forms including, “journaling, art, and role-play.” These allow students to learn and explore emotions in safe, unique, and creative ways. Training can also include presentations and hands-on workshops about building self-awareness, listening, finding commonalities, and respecting differences. Learning how to be empathetic doesn’t have to take place in a classroom setting or linked to medicine. Just Googling “how to be more empathetic” yields thousands of results for practicing empathy at work, with friends, partners, even strangers. The New York Times has a helpful guide for how to be more empathetic with practical steps and advice to put the suggestions into action.

Practicing medicine and practicing empathy both require study, effort, and time. They involve trial and error and maybe even some discomfort. Connecting the two may not be perfect at first, but it’s necessary for better care.