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“Let Me See If I Have This Right …”: Words That Help Build Empathy
- John L. Coulehan, MD;
- Frederic W. Platt, MD;
- Barry Egener, MD;
- Richard Frankel, PhD;
- Chen-Tan Lin, MD;
- Beth Lown, MD; and
- William H. Salazar, MD
- Dr. Coulehan: State University of New York at Stony Brook; Stony Brook, NY 11794-8036 Dr. Platt: University of Colorado Health Sciences Center; Denver, CO 80222 Dr. Egener: American Academy on Physician and Patient; Portland, OR 97210 Dr. Frankel: Highland Hospital; Rochester, NY 14620 Dr. Lin: University of Colorado Health Sciences Center; Denver, CO 80222 Dr. Lown: Mount Auburn Hospital; Cambridge, MA 02238 Dr. Salazar: Medical College of Georgia; Augusta, GA 30902
WORDS THAT MATTER
Consider these two physician–patient dialogues:
1. Patient: You know, when you discover a lump in your breast, you kind of feel—well, kind of—(her speech tapers off; she looks down; tears form in her eyes).
Dr. A: When did you actually discover the lump?
Patient: (absently) I don't know. It's been a while.
2. Patient: (same as above)
Dr. B: That sounds frightening.
Patient: Well, yeah, sort of.
Dr. B: Sort of frightening?
Patient: Yeah … and I guess I'm feeling like my life is over.
Dr. B: I see. Worried and sad too.
Patient: That's it, Doctor.
Dr. A's patient may well go home feeling unheard and misunderstood. Dr. B's patient, while equally distressed about the possibility of having breast cancer, may leave the office believing that her doctor understands her.
One of the most widespread and persistent complaints of patients today is that their physicians don't listen. For their part, physicians complain that they no longer have sufficient time to spend with patients, and they often blame economic pressures imposed by managed care (1, 2). Nonetheless, they acknowledge that personal encounters with patients constitute the most satisfying aspect of their professional lives. They recognize that empathy, the ability to “connect” with patients—in a deep sense, to listen, to pay attention—lies at the heart of medical practice (1, 3, 4).
In clinical medicine, empathy is the ability to understand the patient's situation, perspective, and feelings and to communicate that understanding to the patient. The effective use of empathy promotes diagnostic accuracy, therapeutic adherence, and patient satisfaction, while remaining time-efficient (5-11). Empathy also enhances physician satisfaction (12). As with any other tool, clinical empathy requires systematic practice to achieve mastery (13, 14). Certain well-timed words and sentences facilitate empathy during the …
