Over the years I’ve had the opportunity to offer presentations at academic medical institutions. I’ve been impressed by their commitment to the study and practice of medical science but I noticed a missing component in the education of physicians. That is, there was rarely time allocated for teaching empathy, which could help in gaining insight into the challenges of living with serious illness. What I’ve observed in my work as a medical humanist is that attention to the human side of medicine can lead to improved communication and better-informed decisions about care.
Thinking about the role of empathy in medical practice reminded me of what happened during a presentation to a group of oncology fellows at a world renown cancer hospital. I began the seminar with a screening of the video that accompanies SpeakSooner: A Patient’s Guide to Difficult Conversations. Following the viewing I asked, “What do you hear these patients telling you?” There was a lot of fidgeting but the room was silent. I then asked, “Tell me one thing you heard a patient say, just one thing.”
One oncology fellow sheepishly raised his hand and said “I agree with the patient who said, ‘Doctors have a hard job.’” I responded, “Exactly. But let me finish her sentence. She went on to say that ‘not everyone wants to have these conversations, but some people do.’”
I recognized that his comment reflected a young doctor’s perspective and so I acknowledged that it must be hard to identify with a patient’s experience, especially at times when treatments have failed and there’s increased fear and anxiety. I noted that this could be a very uncomfortable conversation for all concerned.
Then, I asked the group if the video raised any thoughts about communication challenges they’ve faced. Another oncology fellow claimed that there wasn’t time for extended conversations and, apparently trying to lighten the atmosphere, suggested that there may be time for these conversations in Vermont. After some laughter, I looked around the room and proclaimed, “You make time”.
Being aware that the presentation was coming to an end, I thanked them and with a smile said, “Someday, I may be your patient so get ready for these conversations.”
My point in sharing what happened with the oncology fellows is not to criticize this group of young doctors but to bring attention to what needs to be included in medical education to promote humanistic care. The good news is that there are some medical schools that offer seminars on empathy. However, until the role of empathy in healthcare delivery becomes part of a standard educational curriculum, I would suggest that patients remind those trained in medical science about the physical and emotional challenges of living with serious illness. In doing so, it may help them empathize with a patient’s health condition, needs and concerns.
I have learned in my work that empathy is not soft or inconsequential in healthcare delivery. On the contrary, sensitivity to a patient’s perspective can help build trust and foster thoughtful communication in making important decisions about care.
What comes to mind for me in this blog, is whether or not a Young, New or Experienced DR. would like to put the extra time in, to make time for the patient.
Especially when they book themselves so close with appointment times.
In the Oncology Department, maybe time allowance per patient is different, I really don’t know,
Also, I myself, not a Cancer Patient, have had to ask other Specialists to please wait, as they had 1 foot out the door, that I wasn’t finished with what I wanted to say or talk about, along with not understanding.
It makes for a very uncomfortable situation when they only allow themselves so much time per patient.
I believe that Empathy and Bedside Manners are in a person’s heart and mind, but I feel understanding the Patient’s needs can be brought to DR’s attention for sure and experienced, but only if they and Specialists are open to it.
Thank you, Celia Engle Bandman, as you certainly bring much light and awareness to many difficult conversations and practices.