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 Table of Contents  
REVIEW ARTICLE
Year : 2019  |  Volume : 9  |  Issue : 2  |  Page : 104-107

Importance of empathy among medical doctors to ensure high-quality healthcare level


Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia

Date of Web Publication8-May-2019

Correspondence Address:
Mainul Haque
Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Sungai Besi, Kuala Lumpur 57000
Malaysia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AIHB.AIHB_44_18

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  Abstract 


Patients hunt for genuine empathy from their medical doctor. Empathy is an affective mode of understanding. Empathy involves being enthused by another's experiences. However, a leading group medical doctors defines empathy as 'the act of correctly acknowledging the emotional state of another without experiencing that state oneself'. Beyond the field of medicine, empathy is an approach to understanding that precisely involves emotional resonance. However, mentioned definition of empathy primarily gives emphasis to an intellectual component rather than emotional form. Medical educationist and medical professional bodies increasingly recognise the importance of empathy because there are a lot report published regarding poor empathy level among medical doctors. This article will try to discuss emphasising on educational intervention which improves empathy level and its influence on healthcare.

Keywords: Empathy, healthcare, high quality, medical doctors


How to cite this article:
Haque M. Importance of empathy among medical doctors to ensure high-quality healthcare level. Adv Hum Biol 2019;9:104-7

How to cite this URL:
Haque M. Importance of empathy among medical doctors to ensure high-quality healthcare level. Adv Hum Biol [serial online] 2019 [cited 2019 Jul 22];9:104-7. Available from: http://www.aihbonline.com/text.asp?2019/9/2/104/257814




  Introduction Top


Definition

The Society for General Internal Medicine defines empathy as 'the act of correctly acknowledging the emotional state of another without experiencing that state oneself'.[1]

A few quotes

‘When we honestly ask ourselves which person in our lives mean the most to us, we often find that it is those who, instead of giving advice, solutions or cures, have chosen rather share our pain and touch our wounds with a warm and tender hand. The friend who can be silent with us in a moment of despair or confusion, who can stay with us in an hour of grief and bereavement, who can tolerate not knowing, not curing, not healing and face with us the reality of our powerlessness, that is a friend who cares’.[2]

‘Nothing is more important than empathy for another human being's suffering. Nothing – Not career, not wealth, not intelligence, certainly not status. We must feel for one another if we're going to survive with dignity’.[3]

Some definitions

Sympathy and empathy frequently foggy with one another. These two words distinctly have separate meaning. Sympathy has been defined as 'an emotional response stemming from the apprehension of another's emotional state or condition that is not the same as the other's state or condition but consists of feelings of sorrow or concern for the other'.[4] 'Empathy is the capability to share and appreciate the emotions of others imitates emotional understanding'.[5] The implementation and utilisation of empathy are widespread in human life and especially crucial for patient care, where the efficient treatment outcome of patients hinges on operative patient–physician communications.[6],[7],[8],[9],[10],[11] The word empathy denotes the skill to put yourself in the other shoes which is a fundamental skill of extraordinary power and to perceive and interpret what another person is feeling or maybe even thinking.[12],[13] Therefore, empathy is the ability to 'stand in the shoes of another',[14] to consider a situation from someone else's point of view and thereby gain a greater understanding of their perspective which highly required medical science.[13]

Clinical and healthcare professionals' empathy

Empathy, in relation to healthcare professionals, has been defined as an intellectual quality that permits an understanding of the experience, concerns and perspectives of a patient, as well as the skill to communicate that understanding.[15],[16],[17],[18],[19] Furthermore, medical empathy has been described as an exclusive quality for all healthcare professionals, especially a physician as soon as understand patient's concept, impression, state of mind, and provides improved patient care.[20] Empathy has been identified as the nucleus of the success of the health-giving activity.[21],[22],[23],[24],[25] Empathy is also well-thought-out to be the major as an essential component for all health professionals.[15],[26],[27],[28] Therefore, a group of scientists proposes that empathy is 'most powerful tool' for healthcare practitioners to maximise health system outcome as it is an essential component of medical 'professionalism'.[29]

Empathy is one strong communication expertise, as it incorporates a linking and an understanding that comprises the mind, body and soul, and when used properly during a medical interview that is often misconceived and underutilised.[30],[31] 'The medical interview is the practicing physician's most versatile diagnostic and therapeutic tool. However, interviewing is also one of the most difficult clinical skills to master. The demands made by the physician are both intellectual and emotional'.[10] Advantages of better-quality empathetic communication are noticeable for both clinician and patient as empathy cares patients' values, ideas and feelings beyond deductive logic, physical examinations and treatment.[30],[32] Subsequently, this highly effective and influential communication tool builds patient belief, reduces anxiety, improves patient satisfaction, increases adherence to treatment and fewer malpractice complaints, as well as increases physician health, well-being and professional satisfaction and improves health outcomes.[31],[33],[34]

Clinical empathy is a firm supporter to develop a good rapport with the patient. Furthermore, a good rapport with the patient has been reported to have positively correlated with high levels of patient contentment and healthcare consequences.[35],[36] In-depth understanding clinical scenario and technical expertise are essential necessity of medical education and to be a high-quality medical doctor; conversely, interpersonal skills and empathy are progressively more documented as core clinical skills.[37] Multiple research reported that clinical empathy level declines while getting more senior and older.[38],[39],[40],[41],[42] Although ample research studies had demonstrated that more empathetic physicians achieves more professional success because of better treatment related outcomes.[43],[44] A systematic review among medical students and residents reported that empathy started to decline during medical schooling time and in the house-officership period. Thereafter, waning of professionalism leads to poor healthcare quality.[42] It has been reported that both distress and well-being are related to medical student empathy. Furthermore, multivariate analysis measuring distress and well-being concurrently revealed that, both burnout (negative correlation) and well-being (positive correlation) independently correlated with student empathy scores.[45] Another study revealed that scores suggestive of higher medical student burnout were related to poorer medical student empathy scores and inferior professionalism climate scores witnessed in medical students, interns and lecturers. This study utilised the Maslach Burnout inventory, the Jefferson scale of Physician Empathy - Student Version and the professionalism climate instrument.[46] One more study concluded that improved understanding regaining how situational perspective influences the neuro-cognitive mechanisms to reinforce emotional sensitivity and empathy in medicine could contribute to inhibit serious health hazards and improves health professionals' rapport with patient and reputation.[47] As empathy is a highly flexible and accommodative process that permits for the interplay of prosocial behavior in many different social contexts, afterwards, contextual alteration of empathy characterises an adaptive advantage, making the behavior more sensitive to different environment conditions.[48]

A few quotes

'Medicine is an art whose magic and creative ability have long been recognised as residing in the interpersonal aspects of patient-physician relationship'.[49]

'The patient will never care how much you know, until they know how much you care'.[50]

'To attend those who suffer, a physician must possess not only the scientific knowledge and technical abilities, but also an understanding of human nature. The patient is not just a group of symptoms, damaged organs and altered emotions. The patient is a human being, at the same time worried and hopeful, who is searching for relief, help and trust. The importance of an intimate relationship between patient and physician can never be overstated because in most cases, an accurate diagnosis, as well as an effective treatment, relies directly on the quality of this relationship'.[51]

'Every patient wants their doctor to be academically prepared – To know the medicine that they need to know,… but equally important, they want their doctors to have personal attributes that contribute to their professionalism – What a patient might call their bedside manner', that is the view of Dr. Darrell G. Kirch, AAMC President and CEO.[52],[53]

A brief history

Doctor–patient effective communication concept is some 2500 years old. Hippocrates suggested that doctors may influence patients' health.[54],[55],[56] Astoundingly, the hippocratic model is reflected in the hippocratic oath, which emphasises on the trustworthiness of the profession, compassion and human generosity in the practice of medicine.[57],[58] The proficient clinician has a bedside manner that is humanitarian, concerned, empathetic and helpful.[59]

Empathy intervention, medical students and doctor

Quite a few research studies recommend that the eating away of empathy begins in medical school, with the shrillest deterioration in the year III, when most students begin their clinical clerkship and interacting with patients in the hospital.[60],[61] However, one recent educational interventional study found that Jefferson Scale of Empathy score improved rather than declined. In addition, there was a statistically significant (P < 0.001) increase in Groningen Reflection Ability Scale (GRAS) scores.[62] The GRAS was developed to measure the personal reflection ability of medical students.[63] One systematic review studied the full texts of 18 articles (15 quantitative and 3 qualitative studies) and concluded that educational mediations were effective in preserving and promoting empathy in undergraduate medical students.[64] Another systematic review comprising of 64 studies initiate valuable understanding regarding empathy intervention research literature and suggested that targeted interventions had potential to nurture physician empathy.[65] Several original research studies furthermore reported that empathy level could be improved through empathy education.[66],[67],[68]

'Humanists, ethicists, and social scientists agree that empathy is critical – And very often lacking – In medical care'.[69] Furthermore, evidence recommends that doctors with advanced empathy levels – denotes that they are responsive of their patients' emotional requirements and answer applicable to patients' distresses – experience a lesser amount of stress, cynicism and burnout than those with less empathy.[34] Subsequently, medical educators, the authority of schools and overall society are highly concerned about the empathy in doctor–patient relationships.[16],[70],[71],[72] Multiple research studies recommended that careful educational intervention restores high empathy level among medical students and physician to protect good rapport among doctors and patients.[65],[73]


  Conclusion Top


Empathy and professionalism should need to be protected and enhanced to safeguard healthcare globally. Enhanced level empathy will ensure safety measure for physician from burnout. Thereafter, medical schools need to act positively to nurture empathy in both students and physicians.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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