Competence is more important than empathy

[VA Hopeful Dr]

Look, that isn't empathy. That's called building a solid relationship with your patient. It's part of many factors in having rapport with your patient. So, I don't get how you can single out empathy as being more important than any of the other things like professionalism, respect, and effective communication. If you're talking surveys then it's not even about any of this.

And that's fair. Perhaps we are focusing on empathy specifically a bit too much (poor word choice by the OP, I'm now suspecting). Would we all be on the same page if we just filed it as part of building rapport with patients?

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[Crayola227]

Because the point is that so many docs don't really connect on that empathy level with patients, go through all the motions, all the professionalism, respect, and overall effective communication, yet wonder why they leave the room they don't have the patient's consent for the procedure, and others go in and walk out with one.

The article I linked discusses this. The patient doesn't just want clinical detachment. They want to feel and see the concern in your eyes. When they hurt, they want to see it hurts you a little too.

When you seem able to feel or understand as they feel, they are better able to trust that you are making decisions that takes their actual feelings into account. This is why the practice of eliciting the patient's emotional state and then being able to identify what they feel to them, is essential - that is what tells them you are empathizing, and can ensure that you're both on the same page regarding how they feel.

It's more than a nice-nice touch. It actually ensures that your goals of care matches that of the patient, helps you fulfill ethical duties like respecting patient autonomy and beneficience (beneficience is not just determined by objectively positive medical outcomes, it is also defined by the patient). It can direct care and it can affect patient adherence and outcomes.

There, so I think I've made this pretty specific to why EMPATHY, the very definition, is exactly what I'm talking about.

 

[Crayola227]

I'm pretty passionate about the specific role of empathy, and the difference it can make, which is why I was happy to write pages on it in response to the OP's prompt which included the word.

I don't like to see students pooh-pooh the soft skills. The last thing we need are physicians who care think getting the right orders in the EHR matters more than using empathy to its maximally effective usage.

The funny thing is, the very moment in my mind that I chose to be a physician, was when I observed a loved one having a conflict with a physician that to my mind would have been quite easy to resolve with a just a bit more empathy. Then again, I'm a Libra and was the peace-maker in my family.

I didn't know if I could pull off the rest of it, but in that moment, I was like, "I know I can do that better." Perhaps arrogant, but then I've heard it said that anyone who starts down the path has to be a touch arrogant or they would never embark to begin with.

Given empathy was at the very heart of my decision to be a doc... What I see as off-hand dismissals of its importance is one of my pet peeves. Most docs have topics that put them into full on rage lecture mode, that's one of mine.

 

[HomeSkool]

Patients will always have the power to subvert all your best intentions.

That's what propofol is for. Try being nonadherent now, sucker!

People say that anesthesiologists don't need good people skills - and I've never heard that from an anesthesiologist. They play an absolutely critical role in the care of the surgical patient, and what surgeons, anesthesiologists, EM docs, and some other fields all have in common - they have an absolutely tiny amount of time to create enough rapport to do some pretty hardcore things to people.

"Hi, I'm Dr. HomeSkool. Nice to meet you! In the next five minutes, I'm going to poison you. Also, you'll be paralyzed."

I could walk down into our ED right now and talk to every random patient in there for <1 minute and get the diagnosis >90% of the time.

Agreed, getting the right diagnosis is simple. If the patient is talking to you, the diagnosis is insufficient propofol. Duh.

On a serious note, I don't think anyone here is arguing that empathy or communication skills are more important than clinical competence, nor does anyone think they can substitute for a lack of clinical acumen. Empathy hasn't kept clinically incompetent healthcare providers from harming patients for whom they cared very much. But empathy is an essential characteristic of a "complete" physician who provides the best possible care for his or her patients.

Everyone knows the clause (often misattributed to the Hippocratic Oath) "primum non nocere." What does it mean, though? Does it apply only to avoiding sins of commission, like administering an inappropriate therapy or performing unnecessary testing? Or does it extend to sins of omission, like failing to recognize suicidal ideation in your hypertensive patient or being oblivious to the fact that your patient is nonadherent because s/he is unable to afford his/her medication? I contend that failing to gain a patient's trust due to lack of empathy is, in fact, doing harm, because you're failing to address all of the patient's potential health needs while taking the place of a more empathetic physician who could provide more comprehensive care. For that reason, I believe clinical competence and empathy are both necessary qualities of a great physician; I further believe that all physicians should have the goal of being great.

Your combination of competence and empathy determines how good a physician you can become.

• Low competence, low empathy: You belong in Congress.
• Low competence, high empathy: You'll gently caress patients' hands as you kill them.
• High competence, low empathy: You can be a good doctor.
• High competence, high empathy: You can be a great doctor.

 

[Crayola227]

We got to understand that not everyone thinks the way we do. For us who want to be doctors, and be logical about everything, competency > empathy. If possible, empathy and compassion are encouraged, but it will definitely take a back seat to competency, in most of our minds. If you can do both, even better.

Take that to the regular population and there are actually a lot of people who demand empathy and desire better bedside manner from their physicians. And a lot of patients are willing to put up with a lot, when they know their doctor really cares and has amazing bedside manner. I know of one PCP who runs 2 hours behind EVERY DAY! And all his pt's know it. They will all sit in that waiting room two hours past their appt time, just to see him. There are other providers available, but they don't care. They want to see him because he is just so empathetic, compassionate and comforting to them.

Lol, it just occurred to me the perfect example for how a substantial amount of the population is prioritizing experience over efficacy - "alternative" medicine. I'm not talking the stuff where maybe there's a grey zone - I'm talking like the serious quackery.

Patients are eschewing things like measles vaccines for kids, but giving them unpasteurized goat's milk (saw two kids almost die from e coli), and taking them to get their neutron flow repolarized with tissue compressor eliminators and psychic paper.

I never hear from patients what unempathetic jerks those providers are. Granted there's a lot of differences between what we do and what they do, we're frequently required to make much less popular moves than they are.

I think there's a current backlash against Western medicine that while may have benefits, is also causing clear harms.

It's really fascinating to examine the history of "medicine" and being a shaman. Prior to now, a lot of practices had no utility beyond placebo or even causing harm. Often, obtaining that care was expensive, and often the effects weren't particularly pleasant. Oddly enough "negative" effects can create a sort of placebo effect, ie the medicine isn't doing anything if I don't feel anything unpleasant.

So you have to wonder what people got out of it as an institution that's persisted over millennia. I think as a profession we need to figure out whatever works in that model, and make it work for us. Because *just* advancing our medical knowledge and coming up with better treatments is not in any way the end of it.

 

[Stagg737]

As a medical student, my job is to focus on my competence and efficiency first. Empathy and all of that bs can easily be done with a little bit more time when I'm super good at my job.

No matter how hard you work, you're still going to be incompetent at whatever field you enter when you start intern year. That's just how the medical educational process works. If you don't believe me, ask any attending if they'd trust a doctor who never completed residency to treat themselves or their family for anything beyond a common cold.

So you might as well develop those soft skills as a med student while you have minimal responsibility and expectations of your competency are minimal (aka don't kill your patients) than later when you're buried in responsibility and just want to focus on your trade instead of trying to change your learned behaviors.

 

[treebeardette]

'"So what did you learn?" asked Fats. "You learned that uremic skin is brittle, and that the House Privates stink." [...] The BMSs wanted to tell the patient so he could sue. "It won't work," said Fats, "'cause the worse the Private [Doctor], the better the bedside manner, and the higher the patient's regard. If a doctor buys the TV illusion of 'the doctor,' so does the patient. How can the patient know which are the 'Double O' Privates? No way."' - The House of God (1978)

Didn't read the whole thread. Just really wanted to post a House of God quote.

Tired of the empathy vs competence debate. People are empathetic or they're not. The idea that you can somehow develop these "soft skills" in medical school is ridiculous. What you can do in medical school is learn the language necessary to pass the empathy tasks in your OSCEs and have a passing bedside manner. I actually got asked this in an interview and had to swallow the snark. For the record, I am actually super friendly in real life and love talking to most patients. But I am very wary of people who somehow think that a good bedside manner makes up for a less than competent physician. There are plenty of board certified terrible physicians out there who are slowly (or sometimes quickly) killing their very happy patients.

 

[Crayola227]

It's not that a good bedside manner makes up for being incompetence.

It's that competence doesn't make up for a lack of one.

 

[Crayola227]

I disagree, and I know there have been studies to back this up, that empathy for various groups and circumstances, can absolutely be increased in various measures, through education and experiences.

Empathy is quite literally understanding other peoples' emotional states. To act like there isn't a lot we can do to educate providers to facilitate understanding that can extend to the realm of feeling....

I witnessed how my colleagues learning to understand substance abuse disorders on a physiological and not merely moral plane affected empathy and care. Same with a greater understanding of a number of socioeconomic determinants of health and lifestyle choices.

Empathy affects the orders that go in the EHR more than you think.

 

[Crayola227]

I felt the same as you do when I was at your stage of training.

Now I really wish stuff like that didn't matter, but it absolutely does. Can you make a fine living without it? Sure. Will you have more patients, and more loyal patients, with it? Absolutely you will.

Man, it seems like a PITA to do the empathy and likeability thing, but it just hit me... life is sooo much easier when your patients like you. You can't make everyone happy all the time... but being good to your patients and then they like you in return? That is just a sweet day.

I've had days where every one of my patients came in and we all had as good of a time as you can have when there's so much that you can't fix. Compare that to days where I got a lot "done," but I didn't have enough time to make people feel cared for or to do adequate education, and everyone just sorta hated life.

A lot of medicine is not deriving satisfaction from "fixing."

Sometimes the only thing you can give people is that their doctor liked them and was likeable. The fact that people give that much of a shyte what I think and feel about them, wow that is a very special rubber stamp of approval/disapproval to have.
It's like a super-power you have just because patients believe in you. I take a lot of pleasure in sprinkling love around where I can. Sometimes that's all you have to give someone.

 

[Docbel]

its hard to make up for "mess ups" in medicine....

 

[Crayola227]

its hard to make up for "mess ups" in medicine....

Thankfully people are a lot harder to kill than most people think they are.

 

[sliceofbread136]

I think there are actually 2 discussion points here... the transition from open ended to close ended questions and the importance of empathy. Not sure why those two are being conflated here. Often times letting questions be open ended at first helps to keep from anchoring and actually helps makes the diagnosis and serves other purposes besides providing “empathy”

 

[operaman]

I think there are actually 2 discussion points here... the transition from open ended to close ended questions and the importance of empathy. Not sure why those two are being conflated here. Often times letting questions be open ended at first helps to keep from anchoring and actually helps makes the diagnosis and serves other purposes besides providing “empathy”

True. As a consultant though I tend to open with something focused on why they were referred. I’ve been burned too many times when someone will start talking about what’s really bothering them when that thing is waaaaaaay outside our field. Or, my personal favorite, the VA chief complaint: “why am I here? All I know is I got a letter saying I had an appointment.” Obviously I allow them more latitude once we’ve focused on the reason for the visit. This is definitely a big piece of the art of medicine. It isn’t formally taught in schools and probably can’t be because you really have to learn it.

Ironically, where I hated just shadowing in clinics as a student, I actually enjoy it sometimes now because I can see how an experienced attending runs an efficient clinic and handles all these little nuances I wouldn’t have picked up on before. Now I have seen the gamut of styles, and seen those who run late and who are charting at home until 11pm, and those who see twice as many and are done by 5 or 6. I know what kind id like to be when I finish!

 

[sliceofbread136]

True. As a consultant though I tend to open with something focused on why they were referred. I’ve been burned too many times when someone will start talking about what’s really bothering them when that thing is waaaaaaay outside our field. Or, my personal favorite, the VA chief complaint: “why am I here? All I know is I got a letter saying I had an appointment.” Obviously I allow them more latitude once we’ve focused on the reason for the visit. This is definitely a big piece of the art of medicine. It isn’t formally taught in schools and probably can’t be because you really have to learn it.

Ironically, where I hated just shadowing in clinics as a student, I actually enjoy it sometimes now because I can see how an experienced attending runs an efficient clinic and handles all these little nuances I wouldn’t have picked up on before. Now I have seen the gamut of styles, and seen those who run late and who are charting at home until 11pm, and those who see twice as many and are done by 5 or 6. I know what kind id like to be when I finish!

I agree it’s an art and a give and take. I do peds now but I do remember how adults LOVED to ramble about things that were completely unimportant. I think parents with their kids tend to actually focus more on the important issues, however sometimes the same issue arises

 

[operaman]

I agree it’s an art and a give and take. I do peds now but I do remember how adults LOVED to ramble about things that were completely unimportant. I think parents with their kids tend to actually focus more on the important issues, however sometimes the same issue arises

I hear you! In our peds clinics I feel like every parent that comes in knows their kid has an expiration date before they go nuts (if they didn’t already hit that in the waiting room!). No you’re right, most of those are all business and want to gtfo!

 

[Stagg737]

its hard to make up for "mess ups" in medicine....

Actually, plenty of studies have shown that physicians who are more empathetic and up front with their patients are less likely to be sued when they make an error than those who are "better" physicians but are a-holes. Yea, it can be hard to make up for errors, but being empathetic has been shown to help significantly.

 

[Lnsean]

Actually, plenty of studies have shown that physicians who are more empathetic and up front with their patients are less likely to be sued when they make an error than those who are "better" physicians but are a-holes. Yea, it can be hard to make up for errors, but being empathetic has been shown to help significantly.

Could you link the studies? If I remember correctly those studies had to do with doctors who had good communication skills and relationship with their patients, not necessarily empathy.

 

[Stagg737]

Could you link the studies? If I remember correctly those studies had to do with doctors who had good communication skills and relationship with their patients, not necessarily empathy.

Here's an article with several links to studies regarding the topic: To Be Sued Less, Doctors Should Consider Talking to Patients More

You'll notice that while communication was commonly the issue, a couple of the studies showed that it was the direct act of a sincere apology which led to lower rates of lawsuits being filed (aka empathy). Additionally, empathy and communication often go hand in hand, and while they aren't the exact same thing, there is far more overlap between the two than you seem to be acknowledging. The following is a case study on lawsuit in which communication was directly linked by the family to implied empathy (or rather how the lack of communication was directly interpreted as apathy): Unexpected Surgical Complication, Lack of Empathy Triggers a Lawsuit

 

[Lnsean]

Here's an article with several links to studies regarding the topic: To Be Sued Less, Doctors Should Consider Talking to Patients More

You'll notice that while communication was commonly the issue, a couple of the studies showed that it was the direct act of a sincere apology which led to lower rates of lawsuits being filed (aka empathy). Additionally, empathy and communication often go hand in hand, and while they aren't the exact same thing, there is far more overlap between the two than you seem to be acknowledging. The following is a case study on lawsuit in which communication was directly linked by the family to implied empathy (or rather how the lack of communication was directly interpreted as apathy): Unexpected Surgical Complication, Lack of Empathy Triggers a Lawsuit

Nowhere in the first article does it even mention empathy. Communication skills is part of being a competent doctor.
The second article mentions empathy as one of many other many factors. The article's key lessons don't even mention being empathetic.

All this is saying is that communication is key...not necessarily empathy.

 

[Crayola227]

to borrow a line from Goro.... you might feel a slight pressure.

 

[Lawpy]

I didn't read the discussion but I just want to point out that competence and empathy should be viewed as complements not opposites. Competence and empathy are essential characteristics that any good physician must have to be successful.

 

[Stagg737]

Nowhere in the first article does it even mention empathy. Communication skills is part of being a competent doctor.
The second article mentions empathy as one of many other many factors. The article's key lessons don't even mention being empathetic.

All this is saying is that communication is key...not necessarily empathy.

Are you really going to keep up this rigid definition of empathy that suggests it's mutually exclusive from communication and that the two aren't inseparably intertwined? If so, there's no point in continuing this discussion, as you're literally asking for information that not only doesn't exist, but is likely near-impossible to gather.

 

[Doctor-S]

My colleagues and I have referred some patients to a specialty practice that was founded by a well-qualified surgeon (who is known for being empathetic). Later, his son, also a well-qualified surgeon (who is not known for being empathetic), joined his father's specialty practice. They have been practicing surgery together for over ten years.

The surgeon-dad has delegated some of the truly thorniest cases to his son because his son is "absolutely crack" as a surgeon even though his son's bedside manner is no-nonsense and blaaaah. Although the surgeon-dad is qualified to provide the same surgical care, the surgeon-dad has reason to believe the best possible care for "certain challenging" cases will be provided by his surgeon-son.

In an ideal world, we want doctors to be simultaneously competent AND empathetic. However, the world is not ideal, and neither are patients.

 

[Lnsean]

Are you really going to keep up this rigid definition of empathy that suggests it's mutually exclusive from communication and that the two aren't inseparably intertwined? If so, there's no point in continuing this discussion, as you're literally asking for information that not only doesn't exist, but is likely near-impossible to gather.

I mean the title of the thread and OP's question was clearly directed at competence vs empathy.....not competence vs communication skills/interpersonal skills/ empathy/professionalism/respect/honesty.

 

[Stagg737]

I mean the title of the thread and OP's question was clearly directed at competence vs empathy.....not competence vs communication skills/interpersonal skills/ empathy/professionalism/respect/honesty.

Directly from the OP:

In third year, we find more and more that asking open-ended questions and listening to patients talk about whatever, more often than not, leads to a lot of irrelevant information that is useless in taking care of them.

Seems to me like OP was including communication aspects in his question regarding empathy, and as I stated empathy and communication are almost always intertwined. Again, if you want to use rigid definitions there's no point in discussing it or even asking the question in the first place as empathy is a pretty subjective and ethereal concept and measuring it in a truly objective fashion is a fool's errand.

 

[Lnsean]

Directly from the OP:



Seems to me like OP was including communication aspects in his question regarding empathy, and as I stated empathy and communication are almost always intertwined. Again, if you want to use rigid definitions there's no point in discussing it or even asking the question in the first place as empathy is a pretty subjective and ethereal concept and measuring it in a truly objective fashion is a fool's errand.

Umm...no. Communication is a part of any patient relationship...that wasn't his argument. You can communicate effectively without being empathetic. I don't get why you're stretching the definition to fit your argument. I know it was difficult for you to find these silly articles, so to make them work you've got to widen the difinition to include everything under the sun. BUT, Empathy has a specific meaning and definition that anyone here can google up. Here's his argument:

makes me think that empathy and compassion tend to be overblown and sensationalized because they sound nice, and that the real basis of a great doctor lies in competence, and not empathy.

And in case you're still confused....here is the definition from google:

em·pa·thy
ˈempəTHē/
noun

1. the ability to understand and share the feelings of another.

 

[operaman]

Umm...no. Communication is a part of any patient relationship...that wasn't his argument. You can communicate effectively without being empathetic. I don't get why you're stretching the definition to fit your argument. I know it was difficult for you to find these silly articles, so to make them work you've got to widen the difinition to include everything under the sun. BUT, Empathy has a specific meaning and definition that anyone here can google up. Here's his argument:



And in case you're still confused....here is the definition from google:

em·pa·thy
ˈempəTHē/
noun

1. the ability to understand and share the feelings of another.

Alleging that one can communicate effectively without being empathetic is a statement so divorced from reality that I'm at a loss. It's as though you've argued that dragons and fairies should not be allowed to practice medicine without physician supervision. I sincerely hope you're defining empathy so narrowly as a sophomoric rhetorical strategy rather than a truly held personal belief.

I've written at length in this thread already about how empathy is an integral part of effective communication and physicianship. This viewpoint has been universally shared by every other clinician posting here. I'll let our collective voices serve as a more than sufficient rebuttal for any other students reading this.

 

[Lnsean]

Alleging that one can communicate effectively without being empathetic is a statement so divorced from reality that I'm at a loss. It's as though you've argued that dragons and fairies should not be allowed to practice medicine without physician supervision. I sincerely hope you're defining empathy so narrowly as a sophomoric rhetorical strategy rather than a truly held personal belief.

I've written at length in this thread already about how empathy is an integral part of effective communication and physicianship. This viewpoint has been universally shared by every other clinician posting here. I'll let our collective voices serve as a more than sufficient rebuttal for any other students reading this.

The problem is that empathy is defined for us already. It's not up to you or me. Some of you are trying to make up your own definitions to fit your argument. That's what's more disturbing.

 

[Matthew9Thirtyfive]

The problem is that empathy is defined for us already. It's not up to you or me. Some of you are trying to make up your own definitions to fit your argument. That's what's more disturbing.

Okay, but the definition of empathy is “the ability to understand and share the feelings of another.” I don’t know about you, but I can’t do a Vulcan mind meld, and I’m not telepathic. So in order to really understand how someone is feeling about their situation, I need to communicate with them.

 

[Melchizedek]

Umm...no. Communication is a part of any patient relationship...that wasn't his argument. You can communicate effectively without being empathetic.

This is the error in your logic. Effective communication is a conversation and transferring information in a way that both parties understand one another by the end of the conversation. Without the ability to "understand and share the feelings of another" you're throwing information/data/words at someone and hoping it sticks. So yes, effective communication has an empathy component to it.

As for how empathy fits into the whole MS3 issue the OP brings up; You can teach interviewing, taking an HPI, and diagnosing. You can't teach empathy. So the curriculum is designed to teach you the things it CAN and hopes you integrate it with your own empathetic capability.

 

[Stagg737]

The problem is that empathy is defined for us already. It's not up to you or me. Some of you are trying to make up your own definitions to fit your argument. That's what's more disturbing.

No, we're not. We're saying that there are other factors that directly impact how empathy is perceived and "measured" that you're completely disregarding. No one is making up definitions.

Meanwhile, you're trying to to create black and white situations in which everything fits into neat little boxes and have no impact or effect on each other. That line of thought is both childish and evident of a complete lack of any type understanding of abstract concepts. No, communication and empathy are not the same thing, but they are so inter-connected that attempting to completely separate meaningful communication and empathy into mutually exclusive variables while disregarding their relationship is just foolish.

 

[TheIllusionist]

Empathy and competence are not mutually exclusive abilities. There are enough people out there with demonstrable talent in both. We should seek to promote that ideal.

Example: Math and communication skills are both important for a physicist. Is math more central to physics than communication skills are, sure. But isn't a physicist not all that useful, unless he or she can communicate his or her ideas to other people?

In the same way, empathy is important for potentiating the competency contributions of physicians. It is emphasized by higher ups verbally precisely because the incentive structures in place don't reward it all that much. On the other hand, incentive structures, such as better training opportunities with better standardized test scores, consistently reward competence. Competence is constantly assessed and quantified. There doesn't need to be much verbal emphasis on it to ensure it. Not as many concrete rewards exist for demonstrating empathy. However, studies have shown that patients' perceptions of how empathetic their doctor is, impacts how willing they are to be compliant. Good compliance relative to bad compliance, all other things held equal, leads to better outcomes.

In summary, while competence may be more of requisite to one's performance as a physician, insofar as a mean competent physician will generally survive better than an incompetent empathetic one, say whose errors lead to litigation issues, it's still important to verbally emphasize empathy and compliment empathetic individuals, insofar as concrete rewards don't really exist for showcasing empathetic behavior, while they do for showcasing competence, and generally more empathetic behavior, all things held equal, has been shown to improve patient outcomes.

An old addage summarizes it best:

"People don't optimally care about what you know, unless they think you care."

 

[Lnsean]

Okay, but the definition of empathy is “the ability to understand and share the feelings of another.” I don’t know about you, but I can’t do a Vulcan mind meld, and I’m not telepathic. So in order to really understand how someone is feeling about their situation, I need to communicate with them.

Exactly, so communication skills are the basics/foundation. Going above that and being empathetic is good but not necessary. Competence is much more important.

 

[Lnsean]

No, communication and empathy are not the same thing, but they are so inter-connected that attempting to completely separate meaningful communication and empathy into mutually exclusive variables while disregarding their relationship is just foolish.

Thank you for finally agreeing to that. The two are different concepts. Communication skills are the basics/foundation. Going above that and being empathetic is good..but not necessary. Competence is much more important.

 

[Lnsean]

As for how empathy fits into the whole MS3 issue the OP brings up; You can teach interviewing, taking an HPI, and diagnosing. You can't teach empathy. So the curriculum is designed to teach you the things it CAN and hopes you integrate it with your own empathetic capability.

I disagree. You can be an effective communicator without being empathetic...very much like a great professor explaining concepts to you during lectures. There is no empathy there but if he's a great teacher/communicator then you'd still understand right? Yes. The two are different concepts. Communication skills are the basics/foundation. Going above that and being empathetic is good..but not necessary.

As for how empathy fits into the whole MS3 issue the OP brings up; You can teach interviewing, taking an HPI, and diagnosing. You can't teach empathy. So the curriculum is designed to teach you the things it CAN and hopes you integrate it with your own empathetic capability.

Of course, the argument isn't whether empathy is good or bad. It's good. I'm saying competence is much more important.

 

[Mad Jack]

Umm...no. Communication is a part of any patient relationship...that wasn't his argument. You can communicate effectively without being empathetic. I don't get why you're stretching the definition to fit your argument. I know it was difficult for you to find these silly articles, so to make them work you've got to widen the difinition to include everything under the sun. BUT, Empathy has a specific meaning and definition that anyone here can google up. Here's his argument:



And in case you're still confused....here is the definition from google:

em·pa·thy
ˈempəTHē/
noun

1. the ability to understand and share the feelings of another.

I cannot effectively be a patient for a physician that fails to display empathy. There are things I am less apt to share and I am less likely to trust them, regardless of their communication skills. 90% of communication is nonverbal and largely subconscious in nature, and it is in those interactions that you will gain or lose many of your patients' trust.

 

[Mad Jack]

I disagree. You can be an effective communicator without being empathetic...very much like a great professor explaining concepts to you during lectures. There is no empathy there but if he's a great teacher/communicator then you'd still understand right? Yes. The two are different concepts. Communication skills are the basics/foundation. Going above that and being empathetic is good..but not necessary.



Of course, the argument isn't whether empathy is good or bad. It's good. I'm saying competence is much more important.

You're really failing to see that the average patient doesn't give a damn about concepts or mechanisms or anything else you talk about. The biggest factor in whether your patient will do as you say is whether they like you, and the first thing they'll note when discussing any physician is their personal impression and how much they trust them. Compliance is the biggest factor in treatment failures, and the best ways to improve compliance are to have trust in the treatment and to have accountability to their physician. If they like you, they legitimately feel bad for being noncompliant, it really makes your job a lot easier. Much of that likability and trust comes from empathy. All the competence in the world means nothing if you can't get your patients to actually do what you're saying or they don't want to make a return visit because they felt you didn't care about them. Most care isn't that difficult to provide, so added competence above a certain baseline has substantially diminishing returns, as it affects a smaller and smaller group of patients. Empathy affects every patient encounter.

 

[Matthew9Thirtyfive]

Exactly, so communication skills are the basics/foundation. Going above that and being empathetic is good but not necessary. Competence is much more important.

So if you accept that effective communication is part and parcel to empathy and that effective communication is part of being a competent doctor, it follows that a competent doctor will already be utilizing the communication skills necessary to create empathy. The only remaining step would be to choose to utilize that empathy to better treat the patient. In that case, empathy can only make you a better doctor.

 

[Stagg737]

Thank you for finally agreeing to that. The two are different concepts. Communication skills are the basics/foundation. Going above that and being empathetic is good..but not necessary. Competence is much more important.

I've literally been saying that this entire time. I guess I just have to explain everything at the first grade level for you to comprehend it properly.

Again, if you really can't grasp that empathy is as importantly competence once a certain base level of competence is achieved (which maybe you can't understand because you're a pharmacist and probably don't see actual patients other than when they pick their rx up) there's no point in continuing your arguments. And before you chime in on the "but, but...effective communication doesn't require empathy!!" stuff again, realize that patients sniff out the docs with total lack of empathy all the time and drop them. So yes, some degree of actual empathy matters outside a select few field students where we don't interact with patients.

Also, @IonClaws , were you really specifically referring to empathy in the sense of "being able to emotionally relate to your patients", or were you referring to the whole empathy, communication, professionalism spiel that medical schools wrap into one when discussing these topics in pre-clinical years. Clarification would save a lot of time and stupid arguments on this thread.

 

[Lnsean]

Again, I'm not here to say that empathy isn't important. Competence, in my opinion, is much more important.