Cancer Docs' Bedside Manner Often Lacks Empathy

Oncologists who offered more empathic statements were younger than those who didn't, and those who stayed longer to converse with the distressed patient were more likely to have described themselves as highly focused on the emotional dimension of patient care.

The research team concluded that oncologists need better education to recognize and respond appropriately to patients' emotions.

"Oncologists clearly care about their patients," said Pollak. "They wouldn't go into oncology if they didn't. But oncology is a really challenging field, and, in general, oncologists have not been trained in how to communicate with patients. So, it's a pretty difficult situation for them."

"The good news is that the ability to communicate is something that can be taught," she added. "I wouldn't say it's an innate skill. Many doctors who say they are less comfortable conveying emotions with patients suffer from a lack of training. What they need is to be taught how to verbalize how they feel, and there have been several programs around the world that have shown that this kind of communication training can produce good communicators."

Pollak noted that she and her team are now conducting a follow-up study to see how communication skills might improve if oncologists were given personalized CD-Roms to screen video of their own interactions with patient. Data from the study has yet to be analyzed.

Another expert agreed that training could only help.

"The emphasis in medical school is not usually focused on the emotional side of things," noted Kevin Ochsner, an assistant professor of psychology at Columbia University, New York City. "It's about being able to get the diagnosis right. But, in fact, it's as important to communicate that a patient's feelings matter and are an important part of the equation as it is to convey the probability that a certain procedure will or will not have a positive outcome."

"Empathy," added Ochsner, "is the social glue that knits people together because the ability to connect with one another emotionally and to understand the feelings of one another promotes rapport and bonding. So, making patients feel that they're heard will help them feel secure and less anxious. It helps regulate their emotions, and this has all kinds of important mental and physical health effects."

More information

For more on physician empathy, visit the American Medical Association.

SOURCES: Kathryn L. Pollak, Ph.D., associate professor, Duke University Medical Center's Community and Family Medicine Department, Durham, N.C.; Kevin Ochsner, Ph.D., assistant professor, psychology, Columbia University, New York; Dec. 20, 2007, Journal of Clinical Oncology

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