Humanizing Healthcare

In a recent blog post, I discussed the difference between sympathy, empathy, compassion, and pity. We explored how compassion in action can be demonstrated by active listening and motivational interviewing from the healthcare provider, thus allowing the person seeking care to feel open and autonomous in their care plan. 

As a reminder…

Sympathy is signifying a general kinship with another's feelings, no matter what kind.1

Empathy refers to vicarious participation in the emotions, ideas, or opinions of others; the ability to imagine oneself in the condition or predicament of another.1

Compassion implies a deep sympathy for the sorrows or troubles of another coupled to a powerful urge to alleviate the pain or distress or to remove its source.1

Pity is sorrow aroused by the suffering or ill fortune of others, often leading to a show of mercy.1 

Is Burnout Blocking Empathy?

A 2019 systematic review in Burnout Research examined the relationship between burnout and empathy in healthcare professionals. 

The study suggests:

• Empathy is a core element of healthcare and establishing a therapeutic relationship.

• Although empathy is an essential component in providing effective care, it also creates vulnerability for stress-related conditions such as compassion fatigue and professional emotional exhaustion

• Emotional exhaustion is considered one aspect of the burnout construct, (The other two components include: depersonalization and a reduced sense of personal accomplishment at work)

• Burnout reduces the ability of clinicians to respond empathically;

• Being empathic draws significantly on personal resources and thus causes burnout; and

• Being empathic protects clinicians from burnout.3

Empathy can also build trust and improve the patient's perception of their overall medical care and maintain compliance with recommendations from the clinician. 4

Assessing Empathy

The Consultation and Relational Empathy (CARE) Measure rates empathy in the context of the therapeutic relationship during a one-on-one consultation between a clinician and a patient: (All questions are asked from the patient's perspective of the encounter)

• Making you feel at ease

  • (introducing him/herself, explaining his/her position, being friendly and warm towards you, treating you with respect; not cold or abrupt) 

• Letting you tell your "story."

  • (giving you time to describe your condition in your own words fully; not interrupting, rushing, or diverting you) 

• Really listening

  • (paying close attention to what you were saying; not looking at the notes or computer as you were talking) 

• Being interested in you as a whole person

  • (asking/knowing relevant details about your life, your situation; not treating you as "just a number") 

• Fully understanding your concerns

  • (communicating that he/she had accurately understood your concerns and anxieties; not overlooking or dismissing anything ) 

• Showing care and compassion

  • (seeming genuinely concerned, connecting with you on a human level; not being indifferent or "detached") 

• Being positive

  • (having a positive approach and a positive attitude; being honest but not negative about your problems) 

• Explaining things clearly

  • (fully answering your questions; explaining clearly, giving you adequate information; not being vague) 

• Helping you to take control

  • (exploring with you what you can do to improve your health yourself; encouraging rather than "lecturing" you) 

• Making a plan of action with you

  • (discussing the options, involving you in decisions as much as you want to be involved; not ignoring your views)5

First, I recommend starting with self-assessment, then consider scoring your last interaction with a healthcare provider. If you work in healthcare, consider giving it to a patient at the end of the session. As a patient myself, I would be thrilled to know my health care provider is looking for opportunities to better engage and grow empathy for my care. 

Humanizing Healthcare

Since that empathy blog post a few weeks ago, I have been personally seeking to improve listening empathetically and express empathy in my responses. It is most definitely still a significant area of growth. 

As with all things in life, if you are focused on something or looking for something, you will indeed find it! And what I found was the book "Called to Care" by Laurence N. Benz. 

After reading the mission and premise of the book to "humanize healthcare," I bought the book almost immediately. Laurence N. Benz worked on the final chapter and sent it for publication last year when everyone was in definite need of a reminder of their calling and purpose. As healthcare providers, many of us joined our respective professions because we genuinely want to care for others. We desired to save lives and improve lives. But as discussed earlier, amid emotional exhaustion and compassion fatigue, burnout can loom, causing empathy to fade. So to better humanize healthcare, we must all -- patient and provider alike -- work to make empathy a daily practice. 

Here are 3 tips to make empathy a daily practice:

• Develop a mindfulness practice:

  • "Mindfulness practice facilitates awareness and being in the present moment, empathically acknowledging one's experience and encouraging critical examination of personal biases while withholding judgment. Mindfulness practice further enables enhanced attention to the present moment and an 'open heart,' attitudes/practices that are fundamental to empathy. Mindfulness practices have been shown… to enhance the characteristics of empathy and compassion."6

• Make listening a priority:

  • "Empathy begins when you set the intention of listening for emotion. Make an effort to notice the signals people are giving that can indicate what they are feeling." 7

• Notice body language cues in yourself and others:

  • "It has been suggested that body language may account for between 60 to 65% of all communication." 8

  • Eye contact, open posture, open and relaxed arms, removing obstacles ( desk, computer, etc.) between you and the other person all facilitate more open body language.

References: 

1. https://riseservicesinc.org/sympathy-empathy-compassion-pity/
   

2. https://www.calledtocarebook.com/resources

3. Wilkinson H, Whittington R, Perry L, Eames C. Examining the relationship between burnout and empathy in healthcare professionals: A systematic review. Burn Res. 2017;6:18-29. doi:10.1016/j.burn.2017.06.003

4. Hannan J, Sanchez G, Musser ED, et al. Role of empathy in the perception of medical errors in patient encounters: a preliminary study [published correction appears in BMC Res Notes. 2019 Aug 13;12(1):501]. BMC Res Notes. 2019;12(1):327. Published 2019 Jun 10. doi:10.1186/s13104-019-4365-2

5. http://www.caremeasure.org

6. Dean, S. Et al. The effects of a structured mindfulness program on the development of empathy in healthcare students. NursingPlus Open. 2017; 3:1-5. doi:10.1016/j.npls.2017.02.001.

7. https://www.verywellmind.com/how-to-develop-empathy-in-relationships-1717547

8. https://www.verywellmind.com/understand-body-language-and-facial-expressions-4147228

9. Tipper CM, Signorini G, Grafton ST. Body language in the brain: constructing meaning from expressive movement. Front Hum Neurosci. 2015;9:450. doi:10.3389/fnhum.2015.00450

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