By Sarah Whitehouse

When things go wrong, doctors are encouraged to be open with patients, show compassion and communicate effectively. But is there room for empathy, or even emotion, in the clinical setting? 

Traditionally, empathy in clinical practice was bound up with the vague term “bedside manner” – you either had it, or you didn’t. It couldn’t be taught or improved. Now, however, empathic communication is seen more as a taught skill, and one that is essential in order to fully understand a patient’s condition. 

Clinical empathy is about understanding a patient’s symptoms and feelings, and communicating that fact to the patient. It is important to check back with the patient when taking a history to show you fully understand, for example, “Let me see if I have this right.” Verbalising the patient’s emotion, eg. “You seem anxious about your chest pains,” demonstrates active listening.

Dealing with emotion

Sometimes, it is important to know when to step back from a situation. An excess of emotion can blur boundaries. There are a wide range of opinions on what is professionally appropriate. Advice can at best only be general, because of the huge number of differing reactions to a doctor’s behaviour by patients. How doctors react and support patients will depend on the previous relationship they have had, and the knowledge that a doctor has of the patient’s personality.

In providing competent and compassionate care, emotion does sometimes creep in – after all, doctors are human too. However, the empathic doctor should not be willing to indulge idle emotion or self-absorbed sympathy; empathy should be given with a strong clinical purpose. 

Above all, empathy allows the patient to see the person behind the professional, and the doctor to see the person, and the suffering, behind the patient.

Top tips

• Recognise strong feeling (eg. fear, disappointment, anger, grief)

• Pause to imagine how the patient might be feeling

• State how you see the patient’s feelings (eg. “It sounds like you’re upset about...”)

• Legitimise the feeling

• Respect the patient’s effort to cope

• Offer support (eg. “Let’s see what we can do together”)¹