Empathetic responses
====================

* John A. O’Connor

I support what Buckman and colleagues have written about the teaching of empathy in medical schools.1 I would add that it is the patient, not the doctor or faculty member, who evaluates whether a doctor shows empathy. Whereas we can always teach techniques to increase the awareness of doctors about the understandings, feelings and experiences of patients, the doctor does not determine whether he or she comes across as empathetic.

Mercer and Reynold’s article included an “empathy scale,” on which the patient grades the physician in 10 broad areas.2 If the grade shows a lack of involvement, the physician may feel very vulnerable, especially with a difficult patient.

Few patients (and doctors) care about empathy if there is a speedy cure. The paradigmatic example is a surgeon: If you had to choose, would you want a good cutter or someone who understands you? Response by physicians to the patient’s grading could provide additional scope for teaching empathy while acknowledging the need for empathetic interaction between physicians and teachers.

Empathy involves taking the time to know a patient as the patient understands him- or herself. And taking this time, as well as that required for understanding an often complex diagnosis, is in economic terms very inefficient and costly. Increasing the empathic communication of physicians is not independent of revising other system health care values.

Some letters have been abbreviated for print. See [www.cmaj.ca](http://www.cmaj.ca) for full versions.

## References

1.  Buckman R, Tulsky JA, Rodin G. Empathic responses in clinical practice: Intuition or tuition? CMAJ 2011;183:569–71.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxODMvNS81NjkiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTgzLzExLzEyODUuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 

2.  Mercer SW, Reynolds WJ. Empathy and quality of care. Br J Gen Pract 2002;52;Suppl S9–12.
    
    [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYmpncCI7czo1OiJyZXNpZCI7czoxMToiNTIvU3VwcGwvUzkiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTgzLzExLzEyODUuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9)