10 December 2014
Imagine that you are an elderly patient with diabetes. You live on a small fixed income, and the only coverage for prescriptions you have is through Medicare. You don’t have a car so you have to take the bus and then walk to the physician’s office. You arrive with your legs in pain, knowing that it will take you at least an hour to get back home again.
Your physician comes in a half hour late and checks your legs, doesn’t see anything that concerns her, gives you a prescription and says she will see you next month. What she didn’t find out was that you are in so much pain that you may not be able to walk home. She doesn’t know that you have reached your limit for Medicaid and can’t afford to fill the prescription she gave you. You are worried about the choices you will have to make. She doesn’t know that without a car, you can’t easily get to a grocery store that carries the kind of healthy food someone with diabetes should be eating.
How Empathy Can Help
What did this patient need? Empathy. Empathy is what helps us to better understand what another person is experiencing, or, as the old saying puts it, to walk a mile in another person’s shoes. Social determinants of health—where you live, your income, your community and social network, your level of education and your access to health care—contribute to overall health and wellbeing. Providers need to be able to listen for and identify those determinants. “Clinical empathy is an essential medical skill that can be taught and improved, thereby producing changes in physician [and other health care workers who care for patients] behaviour and patient outcomes,” notes a research summary on the ScienceDaily website about a study of empathy.
An empathetic physician could have taken a few minutes to talk with the patient to find out what her day has been like (uncovering the information about the long bus ride). She could have asked about her circumstances to learn about her Medicaid and grocery stores. Then she might have offered help or at least let the patient know she understood her circumstances.
Even patients whose life circumstances are less challenging receive better care from health care professionals who can empathize with them. In a 2014 study, researchers at Massachusetts General Hospital found that “relationship-focused training had a meaningful effect on measured health outcomes—factors such as weight loss, blood pressure, blood sugar and lipid levels, and pain—in patients with conditions such as obesity, diabetes, asthma or osteoarthritis.” In a 2011 study published in the Journal of the American Board of Family Medicine, researchers found that patients whose physicians were rated as more empathetic had higher rates of satisfaction than patients whose physicians were less empathetic.
Yes, But I’m a Student
You may be thinking, “I’m only in high school [or college]. Why do I need to learn and practice empathy now?” Empathy can help you in any situation—from dealing with your parents and teachers to better understanding your best friend and your worst enemy. Being able to practice empathy now will help you be a better health care practitioner (or help you be better in any career you choose—empathy goes a long way with colleagues and clients as well as patients).
For example, imagine a weeknight dinner with your family. Your little brother spills his glass of water. Your mom snaps at him to move as she cleans it up. Silence descends on the dinner table. This is not at all like your usually patient and calm mom. Rather than heading off to your room after dinner, you help your mom load the dishwasher. As you do, you ask how her day went. As the two of you talk, she tells you that she just found out there would be layoffs where she works. Though she will not be one of the people laid off, several of her friends will be.
You recall the time that your best friend in elementary school got held back and how that made you feel. You take the dishtowel out of her hand and tell her to go relax. “It must be really hard on you to think of what will happen,” you tell her. “I’m sorry you have to go through this.” You may even mention what happened to your friend and tell her you have an idea of how she feels.
These suggestions are a few steps you can take now to increase your empathy:
- First and foremost, learn to listen when someone is talking to you. Try not to think about something else or prepare a response while the person is still talking. Give the person and what he is saying your full attention. Focus on the words and the person’s body language.
- Communicate. Elliot M. Hirsch, M.D., a Los Angeles plastic surgeon writing about empathy on the American Medical Association Journal of Ethics website, wrote, “A doctor may be listening carefully to a patient, but the only way for the patient to know that is for the doctor to reflect that he understands the patient's concerns; i.e., to respond empathically.”
- Keep a journal to record your feelings and observations. An article in Nursing Times provides detailed suggestions for keeping a journal.
- Act as if. Even when you aren’t capable of empathizing, acting as if you are may be perceived by the patient as empathy. You also may be able to act your way into actually feeling empathetic.
- Get to know the community around you. The more kinds of people you know, the better you will be able to understand those you come in contact with through your work.
- Educate yourself in the arts. Music, literature and the visual arts are centered on who we are as human beings and how we interact, which is the basis of empathy.
- Practice compassion. Be kind, express gratitude and go out of your way to help others as much as you can.
- Understand the difference between pity and empathy. Even people in the most difficult situations do not want pity. “Pity is a form of judgment, it’s an assertion of superiority—oh, you poor thing!” noted Robin Youngson, M.D., a New Zealand anesthesiologist and founder of the Hearts in Healthcare website, in a column he wrote on the site.
Walking in someone else’s shoes for even a short time isn’t easy, and it’s not necessarily going to feel comfortable right away. It takes practice. Like all habits, though, once you get used to it, you will soon be able to empathize with others without thinking too much about it.