Study: Doctors lack empathy
Raymond
Or perhaps they just don't know how.
"Communication breakdowns are the most common root cause of heath care
errors that harm patients."
---Paul Schyve, chair of the American Medical Association’s Ethical
Force Program's Oversight Body.
Cancer specialists and surgeons rarely respond with empathy to
patients' concerns, suggests a study in the Archives of Internal
Medicine.
Researchers assessed transcripts of 20 audio recordings of
consultations between men with lung cancer and surgeons or oncologists
at a Veterans Affairs hospital. Physicians had 384 opportunities to
show empathy to patient comments such as "This is overwhelming" and
"I'm fighting it."
They missed all but 39 (10 percent) of the 384 chances.
When patients get the empathy that stems from effective communication,
they're more satisfied and more likely to comply with treatment, the
authors wrote.
But responding to patients' emotional needs is one of a physician's
greatest challenges. "They may begin medical school with empathy for
their patients but gradually learn detachment, perhaps in order to
cope with time constraints or sadness," the authors wrote.
Here's one example from the studying showing how a physician responded
when a lung cancer patient received the news that he didn't have long
to live.
Patient: I don't know what the average person does in just two years,
three years, a year?
Physician: I think that you certainly could live two or three years. I
think it would be very unlikely ... But I would say that an average
figure would be several months to a year to a little bit more.
Doctors treating terminally ill patients are constantly straddling the
knife edge between false hope and false hopelessness. Just how,
exactly, are they supposed to deliver the news?
I was sitting in the exam room with my brother-in-law, Kevin, when he
was diagnosed with stage IV lung cancer and given 8 to 10 months to
live. The doctor was unemotional and matter-of-fact, which I
appreciated, given the enormity of the news and the raw emotions we
were all feeling.
But was it what Kevin needed?
Less than three months later, he passed away.
There are several reasons that physicians may not display empathy, the
authors note. They may believe there is no time for empathetic
responses, they may be too busy with other tasks to recognize
opportunities for empathy or they may consciously avoid responding
empathetically, perhaps believing that biomedical information is
reassuring.
Or perhaps they just don't know how.
Allan Hamilton, a neurosurgeon at the University of Arizona, uses
horses and horsemanship exercises to teach medical students the
importance of non-verbal communication and the value of good patient-
doctor relationships.
Hamilton wanted to help rookie physicians learn to deal with difficult
moments, such as when a parent must be told a child has died or a
patient has an unexpected outcome on a test. And he thought horses,
masters of non-verbal communication, were just the teaching vehicle.
Horsemanship comes into play, he said, because it requires the
understanding of body language and sensitivity.
"Since 80 percent of communication is non-verbal, it's a very
important part of life," Hamilton said. "If I look at what makes
patients unhappy, other than bills and waiting, it's that they're not
really sure they can trust the doctor."
in Bedside manners, Death and dying | Permalink
http://featuresblogs.chicagotribune.com/features_julieshealthclub/2008/09/study-doctors-l.html
Raymond
http://featuresblogs.chicagotribune.com/features_julieshealthclub/2008/09/study-doctors-l.html
in Bedside manners, Death and dying | Permalink
October 3, 2008
New study shows doctors miss many chances to show compassion
I don’t know why, but these discouraging studies keep coming – those
pointing to doctors’ lack of compassion. The most recent, published in
the Archives of Internal Medicine, looked at transcripts from 20
consultations between men with lung cancer and their surgeons or
oncologists at a Veterans Affairs .
..
Read more
http://blog.healthtalk.com/bedside-manner/schwartz-center/new-study-shows-doctors-miss-many-chances-to-show-compassion/?comment_id=97