Should Doctors Show More Empathy?

By Carol Levy

So many of us have complained, rightly so, about doctors not listening to us. They often ignore our words.

We tell them where the pain is (my back, my foot, my face, etc.) and how it feels (achy, sharp, throbbing, etc.). But when they repeat it back to us or write it into our medical records, the words are no longer ours. Doctors substitute words that are nothing like the ones we spoke.

Then there is the second part of listening -- of truly hearing what we say – and the feelings and emotions behind our words.

Pain makes me feel desperate, soul sick, and depressed. But in the 40 plus years that I’ve had pain from trigeminal neuralgia, not once have I been asked, “How do you feel emotionally? What is the pain doing to your life?”

In a TV commercial, a doctor describes the difficulty some of his older patients have with numbness in their legs or feet --- and how it’s a safety issue for those who have stairs in their homes. He says he never really understood what they were talking about until he started experiencing the same problem.

What is it about empathy? Is it inherent within us? Or is it something we have to learn and cultivate? Does a doctor have to experience the same things we do before he or she can honestly understand what we are going through?

For a doctor to feel empathy for every patient, to understand and feel viscerally what they are describing, might overwhelm them and cloud their judgement.

The opposite of that, a doctor who is detached or standoffish with patients, may think that allows him to be more objective when deciding on a diagnosis or course of treatment. But it can make them seem cold and uncaring.

Research repeatedly shows that patients want their doctors to see them as a person, not as a list of signs and symptoms. They want a doctor who listens on both levels, hearing our words and the “feelings” behind them.

Beth Israel Deaconess Medical Center, a teaching hospital in Boston, has taken steps to incorporate empathy into the doctor-patient experience. The hospital’s patient intake forms have two questions designed to build empathy.

The first is “How would you like to be addressed?” This allows for a patient to be spoken to respectfully, as opposed to the times when a doctor enters the room and immediately calls us by our first name -- whether we want them to or not. I'm not sure that is a form of empathy, but it is at least treating us like a person, not just “Patient X.”

The second question is “What is your main concern for this visit?" This is asked -- on an intake form -- to ensure the doctor will know our priority. But isn't that the point of interviewing us when they come into the exam room? True empathy would require the doctor to ask us face-to-face, “What is your major concern?” 

So here's the conundrum: Is the better doctor the one who is detached, looks at us as symptoms and test results, and computes the proper treatment?

Or is it the doctor who takes the time to listen to us, to understand our aches and pains, who hears why we’re upset about our symptoms and what they might mean?

If we're lucky, maybe the doctor will be a combination of the two.

Carol Jay Levy has lived with trigeminal neuralgia, a chronic facial pain disorder, for over 40 years. She is the author of “A Pained Life, A Chronic Pain Journey.”  Carol is the moderator of the Facebook support group “Women in Pain Awareness.” Her blog “The Pained Life” can be found here.