Empathy test for doctors?

wasapi

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wasapi
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https://qz.com/work/1726642/should-...y-digest&utm_source=sendgrid&utm_medium=email

A long, but interesting article that begs the question, is empathy a prerequisite for doctors, and something they can be trained? This is of particular interest to me because my doctor is one who lacks empathy, at least to some degree.

An example is that twice now, she has told me, "Yes. You probably have cancer." It was said in a cavalier style. Flat, straight forward way. And, I believe she's wrong, but what a thing to say, shortly before, "Goodbye. I'll call in your prescription."

On topic, what do you think about doctors having to pass an "Empathy Test" when in medical school?
 
Is this to be an empathy test? Capillary dilation of the so-called blush response? Fluctuation of the pupil. Involuntary dilation of the iris.

We call it Voight-Kampff for short.
 
wasapi said:
An example is that twice now, she has told me, "Yes. You probably have cancer." It was said in a cavalier style. Flat, straight forward way. And, I believe she's wrong, but what a thing to say, shortly before, "Goodbye. I'll call in your prescription."
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To me, it doesn't sound like lack of empathy. To me, it sounds like somebody with a slightly sick sense of humor, poking fun at your anxiety as a way of saying, 'Of course you don't have cancer!'
But I wasn't there. I don't know the exact circumstances, so I'm only guessing.

On topic, what do you think about doctors having to pass an "Empathy Test" when in medical school?
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Let's face it, a few doctors who are actual psychopaths manage to get through medical school and job training:
Harold Shipman and List of serial killers by number of victims: Medical professionals and pseudo-medical professionals
I don't think yours is one of them, though. :)


ETA: A few years ago I had a tooth removed. It didn't go smoothly, I was in pain, and the dental surgeon was obviously enjoying himself, even whistling a tune. When the tooth finally got out, he was almost elated and told me enthusiastically about all the phlegm that was released along with the tooth even though I had no desire to hear an elaborate description.
But the operation itself was carried out professionally and effectively, and I wouldn't hesitate to go back if I ever need to have another tooth removed.
(In other words, I don't go the a dentist or a doctor for the empathy or the be comforted. I prefer professionalism and honesty.)
 
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I think empathy is a nice-to-have, not a must-have, for medical professionals. Adding more qualifications to the profession necessarily means getting less professionals. Too, not every med school graduate goes into a job that requires a good "bedside manner." So you'd be burdening many MDs with qualifications they don't actually need to do their job.

Can they do the medicine? Are they ethical? These are the criteria that should be tested in med school. Empathy is something that should be evaluated by employers and patients.

I suspect that a certain dispassionate - even callous - view of the human experience may be one of the success factors in medical practice, especially in surgery. An empathy test in med school may actually be counterproductive.
 
For surgeons in particular, it may take a certain psychological makeup to be able to perform under that kind of pressure. The patient is often putting their life in your hands and not everyone has the heart to do that. Those that do often aren't going to be the most personable people.
 
I think doctors should possess empathy. I saw my doctor about stress and anxiety. After a few appointments and other treatments he told me I seemed much better. I asked him how he could tell and his response was “when you first saw me about this, I felt anxious about your anxiety, but I don’t now”. Pretty good trait I think.
 
Doctor: I'm a Dr House style genius, being rude is part of my charm!
Clinic: We're running a business, not catering to your ego. Your patients hate you and left. You're fired. Find another place to practice your "style" of medicine.

Do as you please, people, but don't expect everyone else to cater to your nonsense. Ask Mo'Nique about being great at the main job skill but sucking at the people skills. It doesn't tend to lead to glittering careers, or job offers, or even lunch invites. Is that unfair? If you think so feel free to pony up the necessary funds to start a medical practice that only employs jerks.
 
The med school interviewers were thrilled that my niece knew some n that was in jail.

Nowadays they do look for more than GPA and class standing. They want social awareness too. Empathy might be hard to estimate with a multiple-guess test. But probably shows in a person's history.

And I've always wondered why doctors choose certain specialties. Some seldom communicate with patients- Radiologists, Pathologists, Anesthesiologists, or maybe into research. A little steering at med school or residency level perhaps ?
 
TragicMonkey said:
Doctor: I'm a Dr House style genius, being rude is part of my charm!
Clinic: We're running a business, not catering to your ego. Your patients hate you and left. You're fired. Find another place to practice your "style" of medicine.

Do as you please, people, but don't expect everyone else to cater to your nonsense. Ask Mo'Nique about being great at the main job skill but sucking at the people skills. It doesn't tend to lead to glittering careers, or job offers, or even lunch invites. Is that unfair? If you think so feel free to pony up the necessary funds to start a medical practice that only employs jerks.
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casebro said:
The med school interviewers were thrilled that my niece knew some n that was in jail.

Nowadays they do look for more than GPA and class standing. They want social awareness too. Empathy might be hard to estimate with a multiple-guess test. But probably shows in a person's history.

And I've always wondered why doctors choose certain specialties. Some seldom communicate with patients- Radiologists, Pathologists, Anesthesiologists, or maybe into research. A little steering at med school or residency level perhaps ?
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This is how it should be. Don't make it a requirement for getting the degree. Let employers and patients screen for it if that's something they want.
 
Like I said above, I don't care if an MD considers me to be a flesh-blood-and-bone machine as long as they know what they're doing. I hate the kind of MD who thinks that what I need is reassurance: 'Everything is going to be all right.'
Tell me exactly what is wrong and what is to be done about it. Then I'll decide for myself if I find the facts reassuring or not.
 
wasapi said:
https://qz.com/work/1726642/should-...y-digest&utm_source=sendgrid&utm_medium=email

A long, but interesting article that begs the question, is empathy a prerequisite for doctors, and something they can be trained? This is of particular interest to me because my doctor is one who lacks empathy, at least to some degree.

An example is that twice now, she has told me, "Yes. You probably have cancer." It was said in a cavalier style. Flat, straight forward way. And, I believe she's wrong, but what a thing to say, shortly before, "Goodbye. I'll call in your prescription."

On topic, what do you think about doctors having to pass an "Empathy Test" when in medical school?
Click to expand...

My answer is a resounding 'no,' based on previous exposure to research on this relatively old debate.

Basically, two reasons:

* empathy still doesn't tell us how socially skilled the doctor will be in terms of bedside manner. this is more about cultural awareness. just as an example, we had a resident expelled because his ethnic culture that assumed male dominance meant he empathized too much with the patient's husband. 'it would be an insult to talk to her directly, he needs to make all the decisions, she should have no information he doesn't approve'

* high levels of empathy is a demonstrated problem for physicians who need to perform procedures that cause patient distress, pain, suffering. highly empathetic gps and surgeons have more complications due to contaminated judgement and hesitation
 
blutoski said:
* high levels of empathy is a demonstrated problem for physicians who need to perform procedures that cause patient distress, pain, suffering. highly empathetic gps and surgeons have more complications due to contaminated judgement and hesitation
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High levels of anything can be counterproductive. A good level of empathy, intelligence, sociability etc. could be a requirement for many jobs, but too much might be inappropriate.

I don't want a doctor who has too much empathy, but neither do I want one who has none. I recently had surgery under general anesthesia, and I was treated with just the right amount of 'empathy' to allay my fears. They were probably all faking it, but who cares? The important thing was it made me feel good about the procedure.

So I think 'empathy' should be a requirement, but only enough to meet basic requirements. And if the doctor can fake it well enough to fool patients then what's the problem?
 
blutoski said:
My answer is a resounding 'no,' based on previous exposure to research on this relatively old debate.

Basically, two reasons:

* empathy still doesn't tell us how socially skilled the doctor will be in terms of bedside manner. this is more about cultural awareness. just as an example, we had a resident expelled because his ethnic culture that assumed male dominance meant he empathized too much with the patient's husband. 'it would be an insult to talk to her directly, he needs to make all the decisions, she should have no information he doesn't approve'
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I have a hard time communicating with ESL Docs. Things like "I think it's in your bailiwick" he didn't understand. Or another that, when I told him my background, he said "why are you telling me this?" Or the one that, after I lost 60 lbs in three months, told me "You have to lose one more pound, you are still 'obese'." Way too many times I get the feeling the only thing they understand is what they learned in med school.

My current fav is a Neuro from Philadelphia. Black guy. Listens, communicates well. He just might become my hero when he finds my Silver Bullet. And his name is actually Tyrone.
 
casebro said:
Or the one that, after I lost 60 lbs in three months, told me "You have to lose one more pound, you are still 'obese'."
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Wow, that's pretty stupid. Makes me wonder if maybe he gets evaluated on how many patients hit target BMI ranges. Either way, it goes back to my earlier quote: "When a measure becomes the target, it ceases to be a good measure." The BMI category boundaries are pretty arbitrary, and if you make those categories your target, they'll be completely useless.
 
theprestige said:
I think empathy is a nice-to-have, not a must-have, for medical professionals. Adding more qualifications to the profession necessarily means getting less professionals. Too, not every med school graduate goes into a job that requires a good "bedside manner." So you'd be burdening many MDs with qualifications they don't actually need to do their job.

Can they do the medicine? Are they ethical? These are the criteria that should be tested in med school. Empathy is something that should be evaluated by employers and patients.

I suspect that a certain dispassionate - even callous - view of the human experience may be one of the success factors in medical practice, especially in surgery. An empathy test in med school may actually be counterproductive.
Click to expand...
I am prejudiced towards that opinion as well. I think a level of empathy a bit lower than the average is probably a factor in providing quality healthcare.
 
Ziggurat said:
Wow, that's pretty stupid. Makes me wonder if maybe he gets evaluated on how many patients hit target BMI ranges. Either way, it goes back to my earlier quote: "When a measure becomes the target, it ceases to be a good measure." The BMI category boundaries are pretty arbitrary, and if you make those categories your target, they'll be completely useless.
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Another time he said I needed to meet other targets too, BP and cholesterol. Or I would be "non-compliant". And so I wouldn't be able to get a job, or health insurance. I told him I was already in SS disability. He replied that non-compliant patients make HIM look bad. (do we have a **** You emoji?)
 
wasapi said:
https://qz.com/work/1726642/should-...y-digest&utm_source=sendgrid&utm_medium=email

A long, but interesting article that begs the question, is empathy a prerequisite for doctors, and something they can be trained? This is of particular interest to me because my doctor is one who lacks empathy, at least to some degree.

An example is that twice now, she has told me, "Yes. You probably have cancer." It was said in a cavalier style. Flat, straight forward way. And, I believe she's wrong, but what a thing to say, shortly before, "Goodbye. I'll call in your prescription."

On topic, what do you think about doctors having to pass an "Empathy Test" when in medical school?
Click to expand...

Look at it this way: You're proposing that this person not be allowed to practice medicine. No matter how skilled they are. No matter how ethical they are. If they can't be sufficiently personable with their patients, they should not be allowed to graduate from med school. They should not be given a license or admitted into a practice.

This seems like a waste of good medical talent.

What are your thoughts on letting employers and patients decide how much empathy they want in their doctors, rather than making it a requirement for graduation from medical school?
 
theprestige said:
What are your thoughts on letting employers and patients decide how much empathy they want in their doctors, rather than making it a requirement for graduation from medical school?
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This whole idea of doctors having to 'graduate' and get a license before they can be admitted into a practice is against free market principles. Let the employers and patients decide what skills they want in their doctors. I bet empathy would be right up there.

And it might just be a good thing overall. Right now many people are going to 'alternative medicine' quacks because they get treated with more empathy - only problem is that's about all they get that has a real effect.
 
Not necessary, they self-select. Lack of empathy they go into low patient contact specialties like surgery, pathology, radiology etc.
 
Could it be cultural?

My dentist is pretty flat about stuff, and he looks at me disapprovingly a lot :) Great dentist though.

As for an empathy test, I hear we have a doctor shortage in this country. After two minutes of thought on the subject, while typing, I'll say no to the test idea. Tell me the truth, doc, give it to me straight.

I'd rather have a doctor that knows what they're doing rather than one who is good at sugar coating stuff. Sure there could be a point where it's too much to tolerate, but some people are easily upset and complain about everything. A constant state of crisis.

I had a bad doctor recently. He was young and arrogant too. I asked for a new doctor (I have crappy Medi-Cal) and I got one. My new doctor kicks his ass. Actually she's a practitioner and correctly diagnosed everything he screwed up. She's pretty wacky too.

No, this whole thing of shooting people down because their behavior isn't perfect has gotten out of control. I've had all I can stand with people wanting to change the world for their own little reasons or because their feelings were hurt.

Her statement - "Yes, you probably have cancer" - sounds like it was in response to a question you asked. If so, how should she have responded?

Sorry if I sound insensitive about this, but I am.
 
People who say others should "have more empathy", especially when those others are people who have dedicated their careers to helping people, are almost always the problem themselves. They're (almost always) making up a false accusation. I'll avoid speculating about what kind of emotional state would cause such behavior, but the details don't matter, because trying to level accusations (even if they were true but especially when they're false) at someone else over one's own feelings is pretty universally a bad behavior anyway, especially when it's done in a context that's deliberately aimed at harming the target.
 
dann said:
(In other words, I don't go the a dentist or a doctor for the empathy or the be comforted. I prefer professionalism and honesty.)
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No, but you probably want them to treat you like a person who has problems and concerns, not a machine that needs rebooting.

They see a lot of sick people and that's probably desensitising, but that's no excuse for some being less than supportive.
 
dann said:
To me, it doesn't sound like lack of empathy. To me, it sounds like somebody with a slightly sick sense of humor, poking fun at your anxiety as a way of saying, 'Of course you don't have cancer!'
But I wasn't there. I don't know the exact circumstances, so I'm only guessing.
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Your'e right about one thing - you wasn't there.

I think wasapi's assessment of the perceived lack of empathy would be closer to the mark than your guess. The subtlety of body language as well voice tone enhance the perception.
 
Yes, I wasn't there, and neither were you, so feel free to guess what happened the same way I did.
 
Skeptic Ginger said:
Why?

You want understanding, not pity if you are a patient.
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Empathy is not understanding, it's feeling.

If I need to have my leg chopped off I don't want a surgeon who is in floods of tears about how horrifying I am finding the whole situation, and I don't want them hesitating because they share my strong fears.

I want a surgeon who makes a decision objectively but understands that for her patient that this is a terrifying situation and is sympathetic about what the patient is going through.
 
For me, it's more about *appropriate* empathy/sympathy, which is different for everyone.

This means that it is very hard to judge, and I do not envy doctors (and other similar professionals) who have to try and modify their behaviour to an ever-changing yardstick. This is why I have avoided customer-facing roles whenever possible. I am not a people person. My social skills are farcical.

Some people need lots of reassurance, and support, and hand-holding. Some don't. Personally, I don't need the emotional support, I just want the facts. Be straight, even brutally honest and realistic. I can handle information in that way. But that's me - most people need to be eased into things to one degree or another.

To use the example from the OP, I'd far rather hear "Yes. You probably have cancer." than be walked around the houses for ages with talk of "doing tests" and "we're not sure". Horses for courses.
 
I think that it might be a good idea to make a comparison with the difference between skeptics and empaths:

If you really feel for people who are losing a loved one and consider going to a quack, you should tell them the truth about that quack instead of helping them keep up their hopes of a miraculous cure and just accept that they are being taken advantage of by somebody preying on them. You can be more or less blunt about it, and there's no reason to be more blunt than necessary, but telling these people exactly what they would like to hear, would be the kind of empathy that only serves to make everything worse.

I wouldn't want to be an MD who has to tell patients and their relatives that the only treatment left is palliative. But on the other hand, it's something that needs to be made clear to them - and if necessary, by using other words than palliative if they are not familiar with it and likely to misinterpret it because it's something they don't want to hear.

Educating doctors about how to handle situations like this would probably be a good idea. I'm not sure that you can teach empathy to grown ups anyway.
 
Worm said:
To use the example from the OP, I'd far rather hear "Yes. You probably have cancer." than be walked around the houses for ages with talk of "doing tests" and "we're not sure". Horses for courses.
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Me too. But my favourite would probably be: "There's nothing whatsoever wrong with you, and we expect you to live a happy life until you're 120! And by the way, have you heard about this new procedure that will restore your hearing 100%?!" :)
 
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