Title: The Impact of Clinical Empathy on Patients and Clinicians: Understanding Empathy’s Side Effects
DOI or website link:
Publication: AJOB Neuroscience
Authors: Helen Riess
Affiliation(s):
Abstract:
Targeted training in empathy can lead to improved clinician empathy by both enhancing perception through self- and other awareness, and optimizing empathic responses through self-regulation and perspective taking, which lead to empathic accuracy and improved patient satisfaction.
Topic Area:
(In which field / sector / perspective was this study conducted?)
(How was empathy defined?)
In the medical profession, empathy has been conceptualized as a communication competency between clinician and patient, in which the practitioner uses various perceptive routes leading to expressions of concern and compassion. These include perceiving sensory/affective cues to identify and transiently experience the subject’s emotional state (Hirsch 2007) and using cognitive abilities such as perspective taking to understand the patient’s experience (Singer and Lamm 2009). These may lead to a potential mutual understanding and helping behaviors from clinicians, or diverging responses leading to clinicians’ personal distress and distancing behaviors.
(What any benefits of empathy mentioned?)
"Trained physicians reported significant improvement in both the perceptive and responsive domains of empathy, which was confirmed by significant improvement in patient satisfaction scores. Trained physicians reported
(1) improved interpretation of patient nonverbal cues (91%);
(2) greater awareness of and ability to manage their own physiological reactions (96%); and
(3) greater awareness and management of their emotional reactions to patients (91%). Physicians were also trained in mindfulness breathing practices that enhanced selfregulation."
(What were the methods used to train empathy?)
"Providing “resilience rounds” for providers could enable them to be more empathic when making patient rounds in hospitals."
(Who participated in this study / training?)
Physicians
(About the assessment: How was the change in empathy measured before/after the intervention/method?)
Result:
(What was the result?)
Say empathy and empathy training in general leads to;
a virtuous positive cycle
improved clinician empathy by both enhancing perception through self- and other awareness, and
optimizing empathic responses through self-regulation and perspective taking,
which lead to empathic accuracy and improved patient satisfaction.
empathically connecting to patients makes doctors feel better.
Posted By: Edwin Rutsch
(Name of the person that posted this page)
Notes:
(Any other relevant information)
Paper says:
Lots of benefits of empathy in medical practice
Physicians well-being is imperiled by the current system.
Clinical empathy is work (emotional labor)
Gives a definition of clinical empathy and how it works.
Situation could be improved with better empathy training.
There is confusion of definitions of empathy and compassion, etc
The Klimecki, singer ., et al. 2013, is an example of confusion.
References:
Bellini, L. M., and J. A. Shea. 2005. Mood change and empathy decline persist during three years of internal medicine training. Academic Medicine 80 (2): 164–167.
Decety, J., C.-Y. Yang, and Y. Cheng. 2010. Physicians down-regulate their pain empathy response: An event-related brain potential study. NeuroImage 50 (4): 1676–1682.
Gleichgerrcht, E., and J. Decety. 2013. Empathy in clinical practice: How individual dispositions, gender, and experience moderate empathic concern, burnout, and emotional distress in physicians. PLoS ONE 8(4): e61526.
Halpern, J. 2001. From detached concern to empathy: Humanizing medical practice. New York, NY: Oxford University Press.
Hickson, G. B., C. F. Federspiel, J. W. Pichert, C. S. Miller, J. Gauld- Jaeger, and P. Bost. 2002. Patient complaints and malpractice risk. Journal of the American Medical Association 287 (22): 2951–2957.
Hirsch, E. M. 2007. The role of empathy in medicine: A medical student’s perspective. Virtual Mentor 9(6): 423–427. doi:10.1001/ virtualmentor.2007.9.6.medu1-0706
Hojat, M., M. J. Vergare, K. Maxwell, et al. 2009. The devil is in the third year: A longitudinal study of erosion of empathy in medical school. Academic Medicine 84(9): 1182–1191.
Jackson, P. L., F. Eug.ene, and M.-P. B. Tremblay. 2015. Improving empathy in the care of pain patients. AJOB Neuroscience 6(3): 23– 31.
Kelley, J. M., G. Kraft-Todd, L. Schapira, J. Kossowsky, and H.
Riess. 2014. The influence of the patient-clinician relationship on healthcare outcomes: A systematic review and meta-analysis of randomized controlled trials. PLoS ONE 9(4): e94207. doi:10.1371/ journal.pone.0094207
Klimecki, O. M., S. Leiberg, M. Ricard, and T. Singer. 2013. Differential pattern of functional brain plasticity after compassion and empathy training. Social Cognitive and Affective Neuroscience April 10: online. doi:10.1093/scan/nst060
Krasner, M. S., R. M. Epstein, H. Beckman, et al. 2009. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary carephysicians. Journal of the American Medical Association 302(12): 1284–1293. doi:10.1001/jama.2009.1384
Larson, E. B., and X. Yao. 2005. Clinical empathy as emotional labor in the patient-physician relationship. Journal of the American Medical Association 293(9): 1100–1106.
Linzer, M., S. Poplau, E. Grossman, et al. 2015. A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: Results from the healthy work place (HWP) study. Journal of General Internal Medicine February 28: online. doi:10.1007/s11606-015-3235-4
Neumann, M., F. Edelhauser, D. Tauschel, et al. 2011. Empathy decline and its reasons: A systematic review of studies with medical students and residents. Academic Medicine 86(8): 996–1009. doi:10.1097/ACM.0b013e318221e615
Pathman, D. E., T. R. Konrad, E. S. Williams, W. E. Scheckler, M. Linzer, and J. Douglas. 2002. Physician job satisfaction, job dissatisfaction, and physician turnover. Journal of Family Practice 51(7): 593.
Riess, H., J. M. Kelley, R. W. Bailey, E. J. Dunn, and M. Phillips. 2012. Empathy training for resident physicians: A randomized controlled trial of a neuroscience-informed curriculum. Journal of General Internal Medicine 27(10): 1280–1286. doi:10.1007/s11606- 012-2063-z
Schernhammer, E. 2005. Taking their own lives—The high rate of physician suicide. New England Journal of Medicine 352(24): 2473– 2476.
Singer, T., and O. M. Klimecki. 2014. Empathy and compassion. Current Biology 24(18): R875–R878.
Singer, T., and C. Lamm. 2009. The social neuroscience of empathy. Annals of the New York Academy of Sciences 1156: 81–96. doi:10.1111/j.1749-6632.2009.04418.x
Tei, S., C. Becker, G. Sugihara, et al. 2015. Sense of meaning in work and risk of burnout among medical professionals. Psychiatry and Clinical Neurosciences 69(2): 123–124. doi:10.1111/pcn.12217
Warmington, S. 2012. Practising engagement: Infusing communication with empathy and compassion in medical students’ clinical encounters. Health 16(3): 327–342.