Empathy In Medicine

The doctor-patient relationship often starts with a diagnosis of a condition or an illness, and the healing process starts with a patient’s perceived connection with the doctor.

There are some patients, after the first second you meet them, you know will be a good fit with your personality. There are some patients who are reserved and anxious, mainly because they are scared of the unknown.

In my dual specialties of hematology and medical oncology, most patients know why they come to see me if they are newly diagnosed with an oncologic condition. That is not really the case for many of the benign hematology patients. Probably about half of those patients have very little understanding of the reason behind the specialty referral. Many are scared when they are advised to see another specialist. The anxiety probably increases by several fold when they see the office entrance  labeled “Hematology and Oncology”. Some of them immediately think of the worst case scenario – they have cancer.

I always believe that medicine is more than merely treating a patient’s physical diagnosis. As human beings function with our mind and body as one, it is important to acknowledge and address the emotional aspects of a patient, especially that related to the physical diagnosis.

When I walk into the exam room, I always greet the patient with a smiling face (yes, still smiling even with a facemask; and yes, I was told by patients they could tell if I was smiling) and look the patient (and any family members present) in the eye. That usually tells me a lot – if the patient is calm or anxious, happy or sad, enthusiastic or indifferent. It gives me a good starting point. Then I usually ask how the patient is doing. Thankfully, most patients are quite honest with that question, instead of the routine social reply of “I’m doing fine”, or simply the word “good”. For new patients, the follow-up question is, “What is your understanding of why you are here today?”  This gives me an idea of how to initiate the discussion.

The importance of empathy in medicine is the vital key for physicians to connect with their patients, so that there is a foundation of trust, an alliance, and a calming space. Patients are more likely to be open about their actual physical and emotional well being, so the physicians may have an even better understanding of what is going on.

Empathy requires you to understand a patient’s experiences, perspectives, emotions and concerns – and that you express this understanding to the patient. In other words, you let the patients know that you are viewing things from their angle, and you understand why they feel what they feel. Without empathy, the doctor-patient relationship might as well be between a patient and a wall that talks.

Some physicians feel that they are already running on dry, with only a few drops of fuel left in their tanks. They feel that they cannot fully express empathy. It is true. If you are filled with emotions such as feeling exhausted, stressed, overwhelmed and burned out, you have no capacity to focus fully on your patients, not to mention to attempt to understand how they are feeling.

To practice empathy during your typical work day, you have to be refreshed and recharged to have the capacity to experience and connect with others. The way to be refreshed and recharged may come in different methods. Meditation, exercise, nurturing your hobby, etc. are some examples. You cannot give what you do not have. Therefore, it is important to have the awareness of when you need to retrieve, reset and recharge.