Posts Tagged ‘Medicine’

From Detached Concern to Empathy: Humanizing Medical Practice

April 27th, 2010

concern-to-empathyHere’s a title that caught my eye, authored by Jodi Halpern. In From Detached Concern to Empathy: Humanizing Medical Practice, Halpern makes a strong case for doctors employing empathy with patients instead of detached concern. Courageously, she points out the healing qualities of empathy as well as the simple practical application in institutional settings. From the Forward:

Physicians recognize the importance of patients’ emotions in healing yet believe their own emotional responses represent lapses in objectivity. Patients complain that physicians are too detached. Halpern argues that by empathizing with patients, rather than detaching, physicians can best help them. Yet there is no consistent view of what, precisely, clinical empathy involves. This book challenges the traditional assumption that empathy is either purely intellectual or an expression of sympathy. Sympathy, according to many physicians, involves over-identifying with patients, threatening objectivity and respect for patient autonomy.

How can doctors use empathy in diagnosing and treating patients rithout jeopardizing objectivity or projecting their values onto patients? Jodi Halpern, a psychiatrist, medical ethicist and philosopher, develops a groundbreaking account of emotional reasoning as the core of clinical empathy. She argues that empathy cannot be based on detached reasoning because it involves emotional skills, including associating with another person’s images and spontaneously following another’s mood shifts. Yet she argues that these emotional links need not lead to over-identifying with patients or other lapses in rationality but rather can inform medical judgement in ways that detached reasoning cannot. For reflective physicians and discerning patients, this book provides a road map for cultivating empathy in medical practice. For a more general audience, it addresses a basic human question: how can one person’s emotions lead to an understanding of how another person is feeling?

After you click the link below, scroll down the page to read the book review from the New England Journal of Medicine.

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A Prescription for Empathy

January 10th, 2010

From the American Psychological Association:

In an effort to improve health outcomes, psychologists are helping physicians become better listeners and patient coaches.

After 25 years as an internist near Buffalo, N.Y., Edward Stehlik, MD, thought he was pretty good at connecting with his patients and helping them manage their health. But like many physicians, he also sometimes found himself distracted by other demands, such as an insurance form he hadn’t finished completing or a colleague’s e-mail that needed answering.

“There’s no question, especially after you’ve been in practice for a while, that there are times when you’re not as engaged with patients as you should be,” says Stehlik, governor of the Upstate New York branch of the American College of Physicians.

So he enrolled in a mindfulness meditation training study being conducted by Michael S. Krasner, MD, and others at the University of Rochester Medical Center. Seventy primary-care physicians attended a yearlong continuing-education course that included an initial eight weekly sessions and a daylong retreat, followed by monthly sessions where they learned techniques aimed at using attention and awareness skills to enhance communication with patients. “Patients know when the provider they’re talking to isn’t completely present,” says Krasner, whose research is published in the Journal of the American Medical Association (Vol. 302, No. 12).

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Mirror Neurons: Understanding the triggers of empathy

December 5th, 2009

In  a recent interview, Neurologist Vilayanur S. Ramachandran spoke to livemint.com about mirror neurons and their influence on empathy. He even calls one type of mirror neuron a “Gandhi neuron.”  Reading the article and watching the video, I’m reminded of the varying understandings of empathy that exist today. One notion, as expressed in this interview, is the ability to “put oneself in another’s shoes” which allows us to have some sense of how another person is experiencing their life.  For others, empathy involves a sense of caring for another.  Empathy can also be simply an unconditional presence to receive the presence of another human being. I experience this kind of empathy as a quality of openness and receptivity that makes no demands and has no agenda.

The main concern I have about this research is that empathy might be reduced to simply mirror neurons firing in response to a stimulus. Reductionism is the unfortunate tendency of “hard” science, reducing inner experiential phenomena to outer observable objects. In this perspective, some people necessarily have more empathic ability because they have more Gandhi neurons. In my experience, empathy can be learned. I have learned and developed empathic skills that continue to grow over time, and I have seen the same happen for others in the circles in which I travel. I guess I just don’t want to confuse correlation with cause.

Read the article and watch the video

Practical Empathy Skills in Healthcare

December 3rd, 2009

Creating a good patient experience is the focus and mandate of the Chief Experience Officer at the Cleveland Clinic, one of the world’s top-rated medical facilities. In this talk, Bridget Duffy shows the theory and practice of patient-centered care, including an on-stage demo of an innovative patient gown.

Nursing Students Learn Empathy for the Aged

December 2nd, 2009

From Daniel McBride of  the Daily Comet  in Thibodaux, Louisiana:

A tightly strapped vest restricts breathing. A weighted jumpsuit unbalances the wearer while pinching joints. Goggles blur vision.

Getting old can feel like this, nursing students tell people who regularly work with patients who are at least 65.

The Nicholls State University nursing faculty developed “Take a Walk in My Shoes,” which takes volunteer nursing students into the community at large to teach caregivers and others how to help and relate to elderly patients.

The tight vest and the bright yellow jumpsuit teaches the wearer about some of the problems her patients face every day.

“It’s not about making these people feel sorry for the older adults,” said Lacey Eschete, a 22-year-old from Thibodaux. “It’s about being empathetic.”

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Empathy in Modern Medicine

November 23rd, 2009

Just posted at the Marin Independent Journal from Dr. Dustin Ballard, in “How to avoid a ‘hardened’ heart”, he writes:

I think you’ll agree that medical care today is truly amazing – most of the time. One area, however, where the system struggles is in the practice of empathy – the acknowledgment and understanding of a patient’s physical and emotional condition. It’s not that we don’t understand the benefits of empathy; on the contrary, evidence shows that patients with empathetic physicians are more satisfied and more compliant with their treatment regimens. Rather, it’s that empathy, in comparison with the nuts and bolts of diagnosis and treatment, is underappreciated and undernurtured.

Dr. Ballard mentions a study where primary care physicians are given “mindful communication” training resulting in a measurable increase in empathic response and then, sadly for me, concludes this type of program is limited in feasibility and results.  I would love to have read how Dr. Ballard reached that conclusion, since the quality and effectiveness of empathy training could easily be dependent upon who provides the training and what their approach and abilities might be.  Nonetheless, Dr. Ballard’s call for more empathy in the medical community and beyond inspires a lot of hope and gratitude in me.

Read the entire article…

For an in-depth look at the humanization of health care in general, I recommend Mel Sears book (Mel is both and empathy trainer and an RN):

Humanizing Health Care with Nonviolent Communication: A guide to revitalizing the Health Care Industry in America

Patients benefit from a dose of empathy

October 15th, 2009

empathy-medicalStudy finds colds lasted a day less with caring professionals

Going to a doctor who understands how you feel and encourages you to get better can do more than boost your spirits. It can also be good for your health.

That’s the message of a study by a team of researchers at the University of Wisconsin School of Medicine and Public Health and the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla.

Patients with colds whose clinicians showed empathy toward them in an office visit suffered one fewer day of misery than did patients whose clinicians took a just-the-facts approach. The research was published in the July/August issue of the journal Family Medicine.

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