Are Doctors Short on Empathy?

A number of news outlets have picked up an article, published in last week’s Archives of Internal Medicine, which suggests that physicians “miss” opportunities to express empathy and compassion in discussions with cancer patients. The researchers noted 384 “empathetic opportunities,” but only about 10% of those received an empathetic response.

The article was fascinating, but I think the press coverage was a bit overstated. The study looked at less than 30 interactions at one medical center, but generated headlines such as: “For Some Doctors, Empathy Is in Short Supply.”

That complaint aside, the findings did ring in my mind as I went around the wards the next day. I started to listen for what the researchers called “empathetic cues.” The examples given in the article were not statements like, “Doctor, I don’t want to die!” but rather things like, “This is overwhelming.”

Now I think of myself as a reasonably perceptive, fairly tuned-in physician. My mental “editor” is on high alert when I’m talking to families of the very ill: I tone down the jargon, and I try and listen to what people are really asking about. (Hint: They rarely want to know the BUN, TV, PEEP, RR, UOP, CVP, or a hundred other bits of alphabet-soup data that matter to me.)

But I walked into the room of a patient with lymphoma and kidney disease, and—as if she’d been reading Archives of Internal Medicine and was there to test me—her first statement was: “Well, I do wonder if this whole thing is going to be the end of me.”

I don’t know exactly what I would have said on a different day. She said it almost jokingly, and we had already told her the kidney issue was a minor one. I might have reassured her about that part of her illness, since that’s my specialty, and then let it go.

But today I decided to take her up on the opportunity.

“Are you worried that you may die of this?” I asked her.

She paused. “Yes, I think I am. I’m old, so it seems silly to worry. I can’t live forever, after all…”

“It’s normal to worry, no matter how old you are,” I said. “I understand this has been hard on you. I don’t think you’re in danger now.”

Her face relaxed a bit. “Thank you, Doctor,” she said.

I think what I learned from the article and my patient is this: While I may be ready and willing to be empathetic, the “opportunity” may require a bit more effort from me. I need to pick up the cues that people give, and then engage in a conversation that elicits their specific concerns and addresses them honestly and with some reassurance. Now, I’ll be on the lookout for those opportunities.

(PHOTO: GETTY IMAGES)