Doctors Own Feelings, Empathy, and Objectivity

I read a fine article in the NY Times Opinionator column titled “Medicine’s Search for Meaning.”  The primary focus of the article is the way the education process of physicians routinely encourages, even demands the physician-in-training to learn to emotionally detach themselves from their patient’s feelings.  This is potentially related to physician burn out, dissatisfaction, and loss of a sense of meaing to their work.

Traditional dogma is that a physician who is emotionally involved in their patient’s issues loses their objectivity and ability to make the best decisions.  Data challenges this assumption.  Per the article, “There is an enduring belief in medicine that if you feel strongly it will cloud your judgment. But research indicates that emotional attunement can improve critical thinking, decision-making, and the ability to act quickly in crisis moments.

As a primary care physician I find that it is simply impossible to open myself emotionally to every patient every day.  Fortunately most visits don’t require a large emotional investment.  Still, learning to read the often unspoken needs and concerns of each patient is important.  The seemingly irrational concern about what to me is an obviously minor concern is usually due to a fear based on something I don’t know about.  This may be due to a previous illness, a family member’s health problem, or maybe an underlying anxiety disorder.  Still, trying to figure out why a patient has a given fear may allow the family doctor to allay the fear in a straightforward way.  If a patient is afraid of cancer, heart disease, a stroke or some other serious problem, and I learn about this fear I am much better able to try to put the fear to rest than if I don’t learn about the real concern.

In order to do this without becoming emotionally exhausted is the trick.  The article talks in detail about an optional curriculum now available at about half of US medical schools that helps medical students develop skills needed to function better in these tough situations and at the same time add meaning, gratification and fulfillment to their calling as physicians.  You may enjoy reading the whole article here.


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