The Empathic Physician

Abstract

Empathy is a process for understanding an individual's subjective experiences by vicariously sharing that experience while maintaining an observant stance. It is a useful tool in the medical encounter as it provides the physician with a fuller, more personalized view of the patient, and it provides the patient with a sense of connectedness to the physician that may allow him/her to more freely express his/her emotional distress. The roots of empathy are explained as a process that evolves from a developmental substrate with the addition of relevant experience, memory, and fantasy. While understanding the patient alone is a worthwhile goal, the physician's empathic insight can have therapeutic impact by its reflection back on the patient, through the use of language, to express support or sympathy, to justify behavior, or to foster deeper emotional expression.

“Could this Be Something Serious?”

“…13 Empathy is widely regarded as an essential element in fostering healing relationships. [36][37][38][39][40][41][42][43][44][45] Our findings demonstrated that the use of specific empathic responses to a patient expression of worry is a marker for greater patient trust, feeling of being known, satisfaction, and feeling supported in their decision-making. Also, empathy was found to be distinct from reassurance, which may paradoxically raise patient anxiety.…”

Behavioral Indices in Medical Care Outcome: The Working Alliance, Adherence, and Related Factors

“…It is difficult to overestimate the importance of empathy in effective medical care and physician behavior 7,8 . Empathy is a fundamental skill in the psychotherapy process, and it has also been implicated as an important dimension of physicians' communication style 9 .…”

“…Multicultural competence stresses the importance of cultural factors in bio-psycho-social processes, and it seems to be an increasingly emphasized dimension of effective medical care, particularly with ethnic minority and immigrant patients. The bio-psycho-social model of health care 13 has evolved in response to the demographic changes that have taken place in the United States over the last 30 years and more recent evidence of outcome disparities for ethnic minority patients who receive medical care 7 . In the current study, multicultural competence is considered a key dimension for physicians in being able to create an agreeable, trusting, and solution-oriented working alliance with their patients.…”

An Overview of Empathy

“…7 However, some studies 1,7,21 found no statistically significant improvement in outcome between patients surgically treated within 24 hours compared with those surgically treated within 24 to 48 hours. Other studies 9,11 suggest that surgery performed on an expedient rather than emergent basis did not compromise neurologic recovery.…”

“…7 Signs of CES include severe bilateral sciatica; bilateral foot weakness; saddle-type hypesthesia or anesthesia in the areas innervated by nerve roots S2 to S5; and retention or incontinence of urine, stool, or both. 9 Thus, asking all patients with back pain about the presence of associated neurologic deficits is imperative and should include questions about lower extremity and saddle paresthesia, numbness, weakness, gait disturbance, bowel or bladder dysfunction, and impotence. 6 Positive responses to these symptoms warrant further investigation to rule out the diagnosis of CES.…”