Is empathy necessary to be a good physician?

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steelydan

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I got into a heated debate over some insensitive comments that a group of pre-med students made about lower SES patients. They were saying things like addicts are just "lazy" for not getting clean and people who can't afford their meds should just work more. It got me thinking about whether or not empathy was necessary to be a good physician. I was wondering what other pre-meds, med students, physicians, and adcoms thought about this topic. Is empathy necessary to be a good physician? and why? It seems like a stupid question, but I was honestly surprised by several of the responses I've received from my peers. Just curious to know what everybody thinks.
 
No it is not required considering how many apathetic people are still doctors.
Schools do try hard to screen for extreme apathy but many people can fake it.
 
I guess the answer to this question heavily depends on your definition of "good." I think you can be a very competent doctor (in the sense of making correct diagnoses, managing complex conditions, good procedural skills etc) without being empathetic. I think empathy comes into play in establishing and maintaining a good patient-doctor relationship which is often necessary to carry out effective treatment plans. If your patient feels judged or misunderstood, they'll probably find another doctor. I think theres a balance between the intellectual/academic side of being a doctor and the social/humanistic side..when either is lacking, you're in grounds for being a not so good doctor imo.

I've also talked to a doc who really doesn't get why applications have to be so well rounded. He thinks it should be dependent on aptitude because its not like you're running for public office. Literally his words. I shadowed him and he's what I consider a good doctor. Though he did lack empathy, I found that he still did respect each patient and even when he made judgements, he kept it to himself. Conversation was short with patients..more of a to-the-point guy. Patients got good care, but I did feel like the personal touch and connection were missing. Hes a heme/onc doc and I personally thought his patients would have benefitted/appreciated more of an empathetic tone considering most of them were emotionally vulnerable cancer patients. I concluded you can do alright/survive without empathy so long as you're respectful and your judgement doesn't hinder treatment but you'd be thriving if you're able to empathize and make that connection with the patient.
 
Some of the most successful physicians I have known have serious issues with regard to lack of empathy and insight. Some of them are even beloved by their patients because superficially they appear to have such things, when behind closed doors they certainly don't. You don't need to be a good person to be a good or a successful doctor, but I'll probably loathe having you as a colleague if you are an animate garbage heap of a human being
 
I think this is one of the more solid views regarding empathy in a medical setting. If you have some time to spare, I recommend it.

 
You need to be empathetic enough to understand how your patient might react to certain diagnoses/treatment plans etc. and to understand the management of their care in the context of their individual cultural and socioeconomic perspective.

You are, however, still a professional. Sitting down and crying with your patient over a bad diagnosis is too much empathy. Not that you cannot share emotions, but you should maintain a professional composure, as you will routinely walk between rooms of a miscarriage followed by a heart attack followed by a pill seeker followed by neonatal lymphoma followed by a cat bite. (This is an over exaggeration).
 
You need to be empathetic enough to understand how your patient might react to certain diagnoses/treatment plans etc. and to understand the management of their care in the context of their individual cultural and socioeconomic perspective.

You are, however, still a professional. Sitting down and crying with your patient over a bad diagnosis is too much empathy. Not that you cannot share emotions, but you should maintain a professional composure, as you will routinely walk between rooms of a miscarriage followed by a heart attack followed by a pill seeker followed by neonatal lymphoma followed by a cat bite. (This is an over exaggeration).
As is your advice regarding keeping those emotions in check. Sometimes you can’t.
 
I got into a heated debate over some insensitive comments that a group of pre-med students made about lower SES patients. They were saying things like addicts are just "lazy" for not getting clean and people who can't afford their meds should just work more. It got me thinking about whether or not empathy was necessary to be a good physician. I was wondering what other pre-meds, med students, physicians, and adcoms thought about this topic. Is empathy necessary to be a good physician? and why? It seems like a stupid question, but I was honestly surprised by several of the responses I've received from my peers. Just curious to know what everybody thinks.
Just because someone is privately expressing some views you think are insensitive does not mean they will treat patients insensitively. Similarly just because someone is sensitive and empathetic in private doesn't mean they will be so with their patients.
 
I think you may be confusing empathy and sympathy. I think that empathy (experiencing/understanding what someone else feels) is really important when you're seeing patients. It allows you to connect with them and get them to open up to you. Once you're seeing patients on your own you'll realize how important that connection is when getting their histories. Empathy is similarly important when you're working as part of a team. The ability to truly understand how your attending/resident/intern/charge nurse etc feel will help you appropriately navigate the waters and build good professional relationships (and get good evals).

Sympathy, on the other hand, eh... I've seen some amazing attendings who really just don't give a flying ****, what makes them great is the connection they make with the patient. Also seen some serious issues with med students and residents who care too much about what is going on.
 
I got into a heated debate over some insensitive comments that a group of pre-med students made about lower SES patients. They were saying things like addicts are just "lazy" for not getting clean and people who can't afford their meds should just work more. It got me thinking about whether or not empathy was necessary to be a good physician. I was wondering what other pre-meds, med students, physicians, and adcoms thought about this topic. Is empathy necessary to be a good physician? and why? It seems like a stupid question, but I was honestly surprised by several of the responses I've received from my peers. Just curious to know what everybody thinks.

It honestly depends on the specialty. Some require a greater show of empathy than others (FM, EM, hospitality, etc.); some, like, rads or path, require very little patient interaction, so empathy is less important. Aside from that, I’d say the biggest thing is can you ACT empathetic toward a patient, regardless of feelings you may have towards them as a person. If you can act like you care about a patient and treat them professional, even if they’re a disgusting person or coming to you with the most ridiculous complaints, then I’d call that success.

So, in summary, no, empathy isn’t a requirement, but being able to act empathetic often is.
 
Yes. I dont get why so many have qualifiers. Physicians...everything we do is literally for someone else. Out careers may have individual upsides just for us, but literally for all medical providers it's all about the patient! And didnt we learn in psych 101 how important it is for child and adult development? Sympathy and empathy are important part of being inherently human, so it should go without saying that yes! Absolutely, it matters as a physician. Does everyone have it? No. Can you still be successful, yes. But think about your teachers...if the, the difference between great teachers and ones who get the job done is how much they relate and care on a deeper level about their students. Even for a pathologist empathy is important. The only 2 things I've ever seen make a person better at their job besides empathy, is fear of failure and money, but those jobs are not patient focused medical related ones. I'm honestly shocked at the comments here :/
 
Imo absolutely yes, heres why:

Life as a physician is not easy. You work long hours and you develop social relationship. Depending on specialty, you see some really messed up stuff. You get invested in people's welfare, and they could either a) not take ownership over their health, or b) die or have something tragic happen to them. You try to provide the highest level of care while constantly fighting with regulations of insurance companies. Despite your intent, you get hit with malpractice suits. And if you're in academia, you get the added bonus of having to play political games to appease or fight back against the higher-ups, especially the ones who aren't physicians or only understand the financial side of healthcare.

At some point, you will struggle with these things and it will emotionally and psychologically wear on you. Critical to staying resilient is remembering your "why"-- why the hell did you get into this messed up profession in the first place? Because if it was to make money, the iBanking ship sailed long ago and you clearly missed it. Imo if you don't have empathy-- if you don't genuinely care for the welfare of your patients-- I don't really see how you'll be able to come out the other side of these things.

Yes you can provide good quality of care by faking it, but I don't see that as a sustainable strategy given the inevitable struggles you'll face. (Almost) every single doctor/person on this planet will face some kind of crisis moment in their lives, and I cant see anything other than empathy justifying being in medicine.
 
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