By the time I reached Dr. R, I was twelve months into an undiagnosed, severe, lower abdominal pain condition. Desperate for an accurate diagnosis and treatment plan after seeing ten doctors who had misdiagnosed me, I was exhausted and beyond frustrated with the care I’d received.
Seated across from Dr. R. in her office with copies of my medical records and symptom diary in tow, I waited quietly while she reviewed my documents. She glanced up from my typed history of the pain, complete with tests and treatments performed, medications prescribed and list of misdiagnoses, and made eye contact. She said, “You poor thing. I’m sorry you’ve been going through this.”
Her words drew tears to my eyes. Twelve months of debilitating chronic pain had wrangled me to a prone position most hours of each day, had chewed my ability to work, and eroded much of my capacity to mother our young daughter. Dr. R. was the only doctor who conveyed empathy. That’s one out of ten.
Empathy is a vital component of care. According to the American Congress of Obstetricians and Gynecologists, “Providing empathic care improves the physician–patient relationship, resulting in improved patient outcomes and satisfaction.”
Is empathy a dying art in medicine? A study published in the Journal of Academic Medicine found that empathy erodes in medical students by the third year in medical school.
Because current medical education emphasizes detachment and clinical neutrality and places greater emphasis on technology, rather than on humanism in medicine, are we churning out physicians poised for physician burnout?
Physician burnout erodes empathy toward patients and mitigates physicians’ feelings of effectiveness and capacity to contribute meaningfully. The AHRQ Safety Network states, “Burned out clinicians may develop a sense of clinical detachment from their work and view people — especially patients — as objects.”
Physicians spend much more time now on data entry to fulfill electronic health record (EHR) requirements as mandated by the ACA. According to new research in Mayo Clinic Proceedings, the demands of EHRs are increasing burnout in physicians.
I can’t imagine what might have happened if Dr. R. had been burned out and hadn’t been capable of being empathic in my first visit with her for my pain condition. I’d already spent a year seeing ten doctors, some repeatedly, and not one treated me like a human being who was suffering. I had begun to feel like a robot that simply presented medical records, reported symptoms, submitted to tests and treatments, and answered questions.
On that same day, Dr. R. also said, “I’m going to do my best to help you.” And boy, she sure did. I knew I had a smart and kind physician in my corner who actually cared, enough so to do research on my symptoms on her own time. If hernias in women hadn’t been so rare at the time, I know she would have nailed the diagnosis. She came incredibly close.
The cause of my pain turned out to be caused by a muscle tear in my C-section site with nerves pinched in the tears and an inguinal hernia with a nerve trapped in the opening. By chance, I found the diagnosis in a New York Times article, In Women, Hernias May Be Hidden Agony, http://www.nytimes.com/2011/05/17/health/17brody.html by recognizing my symptoms in a patient portrayed in the article.
I hunted down the hernia specialist/surgeon Dr. T., who healed the patient in the article. Lucky for me, she was located in my city, and I made an appointment. Dr. T. also conveyed empathy toward me. In my first visit with her, she responded to my tears with a hand on my shoulder and said she thought she could help me. Dr. T. healed me through surgery, and I’ve been pain-free for five years.
Among the twelve doctors I saw for the pain over 16 months, two showed empathy: Dr. R. and Dr. T. They are the only physicians I still see and feel bonded to. I’m immensely grateful to both of them.
With the emphasis on technology in medicine and intense demands on physicians, let’s not forget just how important empathy is — to the patient and to the physician. After all, isn’t the doctor-patient relationship the cornerstone of quality and safety? Perhaps it’s one salve for physician burnout too.
Martine Ehrenclou is a patient advocate. She is the author of and the Take-Charge Patient and Critical Conditions: The Essential Hospital Guide to Get Your Loved One Out Alive.
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