The theme for this month on the WebPT blog is innovation, and they’ve been highlighting new ideas for business, technology, products, and marketing. As I thought about innovative concepts in physical therapy, I was brought back to an old concept: empathy.
Empathy has been defined as the capacity to recognize emotions that are being experienced by another sentient or fictional being. The English word is derived from the Greek word ἐμπάθεια (empatheia), "physical affection, passion, partiality," which comes from ἐν (en), "in, at" + πάθος (pathos), "passion" or "suffering.” Hermann Lotze and Robert Vischer adapted the term to create the German word Einfühlung ("feeling into"), which Edward B. Titchener then translated into the English term “empathy.” (Source: Wikipedia)
What initially drew me to the profession of physical therapy as a high school freshman was the combination of art and science. I briefly considered medical school, but quickly decided that I wanted to spend time with my patients and develop a relationship that didn’t seem possible in the confines of a five- to ten-minute office visit every few months.
I entered physical therapy school not long after the advent of managed care and insurance restrictions. I graduated when it was still possible to spend at least 30 minutes treating a patient and listening to their concerns. Over the past 15 years that I have practiced as a physical therapist, I have watched the science aspect grow to overshadow the art of our profession. Thus, physical therapy became a “doctoring profession” and insurance restrictions led to decreased time spent with patients.
I am thrilled with the emphasis on evidence-based medicine, and I am grateful for colleagues that challenge my thinking and help me grow. I know the benefits of tracking outcomes and the necessity of outcomes for justification for care. These are the best aspects of evidence-based care, and yet, I fear that as we become more focused on evidence and outcomes, we also become less focused on the art of providing care. I would hate to see this happen to my chosen profession.
We are in a position to provide quality, evidence-based care combined with empathy. Even in the current healthcare climate, therapists spend more time with their patients than any other healthcare provider. We need to preserve the art of listening with empathy and providing care that honors the patient’s feelings and goals.
A recent article in the March American College of PhysiciansInternist Journal highlighted the findings from several studies on the topic of empathy in medicine. One study of 242 Italian primary care physicians and 20,961 diabetic patients, which was published in the September 2012 issue of Academic Medicine, found that patients whose physicians scored highly on an empathy test had significantly fewer acute diabetes complications.
Mohammadreza Hojat, PhD, a study coauthor, stated that empathy “involves an attempt to understand the patient as opposed to an attempt to feel for the patient, which is sympathy. A capacity to communicate this understanding combined with an intention to help is part of the definition.” Hojat also noted that “curiosity is an important component of empathy in medicine; curiosity grounded in concern or respect for the patient.” When we engage with our patients, we can develop an understanding of them as people and anticipate their behavior. This is especially helpful when treating patients who are dissimilar to us in age, gender, culture, or socioeconomic status.
Here are a few concrete suggestions for conveying the empathy that you hopefully already have for your patients:
- Recognize when you are distancing yourself from the patient because of beliefs that healthcare providers should be detached. Make an effort to connect in a professional way.
- Be aware of frustrations and prejudices that may arise when interacting with a patient who is different than you in any way (beliefs, culture, language, etc.). Connect with him or her on a human level.
- Express curiosity and interest by asking the patient “How are you?” or “What’s going on?” You can listen to the patient’s concerns while you work, allowing him or her to feel “heard.”
- Use non-verbal communication that signals interest and respect.
- Make every attempt to avoid interrupting the patient, unless it is for the purpose of gently leading him or her back to the question you need answered.
- Make the most out of the time you have with your patients. Let them know you are concerned for their well-being and that you understand their challenges.
Innovation and change are necessary for moving forward as a profession, but we need to remember the importance of good old-fashioned empathy in building positive relationships and working toward successful outcomes with our patients.