Should doctors have empathy?

Yes

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by W. Diane Van Zwol

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Doctors and Empathy: Treating Patients Effectively

Should doctors have empathy? Yes, of course, doctors should have empathy, especially when it involves treating their patients. It is actually the only way that doctors can treat their patients.

What is empathy?

In its literal translation as 'in feeling', (1) empathy is understood as the 'capability to share and understand another's emotions and feelings.' (2)

We expect doctors to have that capability. In fact, we go to them with that expectation, otherwise we would not be seeking medical advice and/or treatment from them. The doctors we visit are medical professionals, who can and will understand what we are trying to convey to them, about our medical or health-related concerns.

For example, a male patient visits a doctor to have some sutures removed, following a bout of surgery. He knows that this doctor will understand what he tells him, about the status of his incision. He assumes the doctor will then do whatever is required, with regard to effective treatment.

Taking the definition of empathy further, it is the ability to "put oneself in another's shoes." (3)

But if you have you ever tried to wear someone else's shoes, you soon realize that no matter how hard you try, those shoes probably won't fit your feet properly. They may be too large, small, wide or narrow. In fact, they may hurt or damage your feet, when you try to wear them. Blisters from wearing someone else's shoes are certainly not much fun! Ask any child, who has had to wear his or her older brother or sister's shoes and then walk a mile to school in them. Problems arise when you try to wear other people's shoes, because you are a different person, as well as being someone unique with different feet than the other person whose shoes you are trying to wear.

"Walk a mile in my shoes?"

Taken literally, that may not always be such a good idea. This also suggests that according to this particular definition of empathy, something may and probably will be lacking. In this case, what is lacking is the perfect fit. Certainly, doctors and patients often share the patient's medical concerns. Doctors appear to understand patient's emotions and feelings, at least to some extent. Be aware that this is always going to be imperfect at best too, because the shoes do not ever fit perfectly. The shoes may almost fit, but that is not sufficient for someone who has to walk a mile, wearing them. In other words, at best, the doctor understands the patient only in part or objectively, rather than subjectively. He is merely the outsider, looking into the patient's medical or health care scenario.

For example, the male patient reporting to his doctor about his post-operative surgical incision informs the doctor that he is still experiencing some numbness, in the surgical area. The doctor may know what numbness in the surgical area means or signifies, even though he cannot feel it himself. He still lacks the total patient experience, even though he may be quite astute in his understanding of what numbness is and how it feels.

Let's take this one definition one step further, by looking at the Greek word "empatheia" (4), which is understood to mean "physical affection, passion and partiality" (5) or a combination of the Greek words "en pathos" (6) signifying "in feeling" (7).

Theodore Lipps created the German expression, we now understand as "feeling into". (8) By this definition, the doctor is essentially seeking to understand, explore or objectively "feeling into" what the patient is stating, reporting or experiencing. Remember that the patient always has the subjective experience and not the doctor. The doctor's experience is purely objective. The doctor is in a position of trying to comprehend the patient's actual experience or reality, from an outsider's perspective.

The doctor still may have high regard, affection or love for his patient. The doctor may be passionate about his work, as a doctor and even show distinct partiality towards his patient, at times. But at best, he is only able to 'delve into' the matter at hand, to the extent that an outsider can touch upon another person's actual experience.

For example, if the doctor could feel the patient's lack of sensation or numbness in the post-op surgical area, he would know the exact extent of it immediately. Because he is not the patient, he has to ask the patient where the numbness is, as well as how extensive it is, at that particular moment in time. Then, he can decide whether this is something that he should be seriously concerned about, at this particular time.

For example, when the patient who has just had back surgery, states that there is numbness around the immediate area of the incision, that is not going to trigger an alarm in his mind. Patients often experience numbness, around a surgical incision. If the patient states that the numbness extends down to his feet, then there is reason for the doctor to be concerned. There may be back and nerve problems that require further investigation, diagnosis and treatment.

The ancient Greek word, "alexithymia" (9) meaning "without words for emotions", (10) sheds more light on the meaning of the word empathy, as it signifies "a state of deficiency in understanding, processing, or describing emotions in oneself." (11)\

From this perspective, one can begin to see the reality of the true meaning of empathy, in terms of the role of the doctor. Empathy distances the doctor from the patient, at least to some extent. The patient's medical scenario would totally consume or devastate the doctor, if this was not so. That could render him impotent to help the patient or make him ineffective, in terms treating him effectively.

For example, the patient in the doctor's office screams in pain when he tries to move his legs, as the doctor examines him. The doctor does not resort to screaming in pain too. The doctor does not experience either the pain or the same emotions that the patient is experiencing, at that exact moment, even though he might be concerned or become alarmed by the screaming.

Thus, in this kind of a situation, the doctor demonstrates a lack of words for emotions. His understanding, processing or describing the same pain and emotions, as being his own, are lacking or deficient. Only the patient can do that. This allows the doctor to distance himself, far enough away from the patient, to be able to treat him effectively for his pain. He goes on to prescribe pain medication for the patient and suggests that physiotherapy will help him to become increasingly mobile again.

Yes, doctors should have empathy. It is a good thing. In fact, doctors need empathy in order to treat patients effectively.

1. http://en.wikipedia. org/wiki/Empathy

2. Ibid.

3. Ibid.

4. Ibid.

5. Ibid.

6. Ibid.

7. Ibid.

8. Ibid.

9. Ibid.

10. Ibid.

11. Ibid.

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