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    « Building a Healthy Community, One Child at a Time | Main | When Doctors and Nurses Can't Do the Right Thing »

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    Edd Volpintesta MD

    January 31, 2009
    New York Times Blog (response to Dr. Pauline Chen’s “The hidden curriculum of medical schools” YJHM -posted Jan. 29, 2009)

    I am skeptical about empathy being taught. I mean real empathy, not the superficial kind that may be mimicked just to please a professor. It is more likely that empathy is learned in childhood from one’s parents or relatives. It may even be genetically related. But, who can say for sure?
    The empathy I see is the perfunctory variety tossed off by saying hello when entering patients’ rooms or calling them by their first names. It has some value but patients can tell if it is genuine and if their physicians are truly connecting and concerned.
    Taking courses in the humanities is helpful for expanding one’s critical faculties and studying great poetry or novels may give insights into patient’s inner turmoil, but whether they can teach students to actually embrace empathy as healers and make it a permanent addition to their medical skills for the rest of their careers is questionable. The seeds of empathy can be sown but unless the ground is fertile, its roots will be weak.
    Unfortunately whether empathy can be taught or not, many difficulties obstruct its being applied effectively. Doctors today are constantly distracted by a stream of little interruptions throughout the day. Any single interruption is minor but collectively they form a tsunami of distraction. Most doctors find them overwhelming and exhausting. Day and night, their fax machines are spewing lab reports, CAT scans, pharmacy requests; visiting nurse forms and home health agency forms—all of which need to be reviewed and either signed and faxed back or acted on by calling a patient or ordering a confirmatory test. Not to mention the many phone calls from patients that must be answered.
    Exercising empathy in a suffocating environment like this would be a challenge even for a saint.
    When teaching empathy medical school and residency educators should tell the students the obstacles that they will face in private practice that discourage empathy. Eliminating the multitudinous distractions that make medicine almost impossible to practice humanely is one important way to assure the survival of empathy in medicine.

    Ed Volpintesta MD

    newport driving school

    I think "bedside manner" should be taught. Like anything else, you either get it or you don't, but it should be required like any other course, and you should have to take a refresher every five years. Doctors are busy when they are working, but aren't we all? Taking the time for compassion is the kind of doctor I want.

    Pauline Chen

    Thank you, Dr. Volpintesta and newport driving school, for your comments.
    Also, for those who might not know, Dr. Volpintesta writes excellent and thoughtful blog posts on the Yale Journal for Humanities in Medicine (http://blog.yjhm.org).

    meverett

    Comments are moderated, and will not appear until the author has approved them.

    Isn't that censorship?

    Melissa Ott, RN, MS, NP-C, FNP

    Entering this discussion far too late to probably weigh in, but nonetheless, as an advanced practice nurse, an educator and one who has been in the trenches for many years, I see it this way. The majority of nurses have internalized abilities to provide care with empathy and caring is what we do. For the most part, those of us who are really in tune with the fact that we are nurses, and never wanted to be doctors, realize the fundamental difference between us in the delivery of health care. We got in to the profession knowing it is a caring one and also because we do care. The majority of those who choose medicine are cynical because they enter into the arena with dreams of country club lifestyles, they are in it for the money, empathy was never part of their plan.

    Bob

    You can teach good manners and empathy.

    The comments to this entry are closed.

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