The emotional state of doctors can affect patient care

Great doctors listen to their patients.

They start out by asking open-ended questions, and unless patients get too far off-track, they don’t typically interrupt them. Despite having limited time for appointments, they have an unhurried manner. They make eye contact with their patients and do not bury their heads in charts and computer screens. Their patients leave their appointments feeling respected and heard.

Of course no doctor is likely to be able to do all of these things all of the time, but some come closer to this ideal more consistently than others.

But great doctors additionally have a “sixth sense.” They can “read between the lines.”

It’s vital that physicians listen to their patients, but human beings are complicated and sometimes do not say what they mean or mean what they say. Or, they may not even know for sure how they feel. Therefore, listening to a patient’s words alone is not enough.

Exceptional physicians have honed the skill of reading non-verbal cues as well as easily-missed subtleties of spoken language that help them to interpret their patients’ histories with greater accuracy. Ultimately, since they are able to connect with and truly understand their patients better, they have the potential to provide superior care.

But, wait. There’s an invaluable clinical pearl that physicians can borrow from the world of psychotherapy to help them to better hone this “sixth sense.”

I’ll explain.

Have you ever been around a negative, depressed person for too long? Or too many negative, depressed people in a short period of time?

How did you feel?

Let me guess–you probably felt depressed or “blah” yourself.

What about someone who was in a very happy and joking mood?

Did you want to smile and maybe laugh?

And that’s the “secret”–it’s actually quite simple: The feelings that others elicit in you are often reflections of their own internal mood states. So, how you feel in the presence of someone very well might be similar to what they are feeling.

I’ve seen this occur from being around people experiencing other emotional states as well.

An anxious, obsessive, fearful person often creates a sense of anxiety, tension, and unease in those around him.

An untrusting or even paranoid person often causes others to feel suspicious.

The list of possibilities goes on and on.

And while this “window” into a patient’s emotional state is not always reliable, it often is. It’s potentially important “information” that shouldn’t be ignored, regardless of a doctor’s specialty.

In addition to providing a clue about the patient’s own feelings, there is another reason that I believe it’s helpful for doctors to be tuned into our own emotions. Our emotional state can impact patient care.

As physician blogger, Rob Lamberts, points out, the doctor-patient interaction involves two humans. He states:

Patients forget that doctors have bad days, get depressed, are sometimes sick, and can be as irrational as patients. We are forgetful at times, don’t always think of things that may be obvious, and even get distracted at times. Sometimes our kids annoy us, sometimes our marriages are bad, some of us have our own past trauma, and sometimes the patient immediately before your appointment was very difficult.

With regard to being “irrational,” that’s exactly what can happen when we have strong emotional reactions to our patients: We doctors can easily lose our objectivity. Making diagnostic and treatment decisions when in an overly emotional state can jeopardize good patient care.

So, what can physicians do?

We can try to pay more attention to how we feel when we’re with our patients. If we notice ourselves having strong emotional reactions, whatever they may be, we should remind ourselves that they may mirror our patients’ mood states. By simply getting ourselves in the habit of being more mindful of our emotions, I believe we’re less likely to allow them to inappropriately sway our clinical judgment.

Jeffrey Knuppel is a psychiatrist who blogs at Lockup Doc, where this post originally appeared.

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  • Anon Doc

    As a doctor who has struggled with depression and anxiety I would agree 100%. I care greatly about my patients but when depressed or anxious I am less decisive and interactive. In medical school I was very depressed at one point and the clinical supervisor thought I was disinterested in the rotation. She had no clue as to what was going on beneath the surface. Attention to the mental health of health professionals is critical to our healthcare system.

  • Ed Pullen

    I’ve found that there are times when I can be at risk to make errors because I want the patient to be OK too much to be objective. This can happen when I have family obligations to get home on time, or when I know the patient very well and am not emotionally ready for a “bad diagnosis.” I have learned to be especially careful in these situations to focus on being objective and mindful of this personal falibility. It just takes a deep breath and thinking twice usually.

  • Deborah Munhoz

    In the midst of so much noise about what is not working in health care and lack of funding- so nice to be reminded about the essence of healing- the human connection. Being mindful of our current emotional state is a great reminder and it all starts there. Putting systems and structures in our lives for life/work balance support our staying in this resourceful, connected emotional zone with greater frequency. But only if they align us with our values, passion and true intentions. Like what made you want to be a physician anyway?

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