Having taught undergraduate medical students at Southampton University Medical School for over 20 years I have finally hung up my cap and gown ( or white board marker pen and flip chart) and will miss their wonderful naive enthusiasm, hungry enquiry yet ruthless questioning. One of the precepts I endeavored to instill in them was the lifelong need to retain their natural humanistic communication skills.
On a friend’s blogsite Heroes not Zombies today I came across a link to a discussion of a research review in the journal Academic Medicine how medical students appear to lose a degree of their empathy as they pass through medical school. Frighteningly one medic had suggested that there should be a split into ‘talking medicine ( that of general practice, primary care medicine) and ‘scientific’ medicine ( that of the surgeon and acute care specialist i.e. without the ‘talk’ bit).
Vaugn Bell of the “Mind Hacks” blog states:
The occasional reply to concerns about physician empathy is usually something along the lines of “what would you prefer, someone who is a good clinician or someone who is a nice person?”.
Despite the false dichotomy, the study make it abundantly clear why empathy is important in medicine, as it is associated with:
• patients’ reporting more about their symptoms and concerns
• physicians’ increased diagnostic accuracy
• patients’ receiving more illness-specific information
• patients’ increased participation and education
• patients’ increased compliance and satisfaction
• patients’ greater enablement
• patients’ reduced emotional distress and increased quality of life
I would want my surgeon or ITU physician to achieve that.
Empathic communication skills are taught in most medical schools now. Can empathy be taught? What should be taught is:
- how not to lose empathy,( i.e. feeling for others) just because one is subjected to a rigorous scientific learning load
- the means of protection from the emotional trauma of dealing with the tragedies of life disease and death
- not to let the science of medicine oust the art. As one respondent on the blog wisely said “
” I had an excellent GP who used to bemoan that many doctors forget (or never get) that medicine is an art as well as a science.
That ’art’ should be include ‘treatment’ – the way that one human being (the doctor) treats another (the patient). And an understanding that suffering, whether one can physiologically detect it or not, is, nevertheless real.
To those with ‘difficult’ diagnoses this makes all the difference.
I understand that there are time limits and that medicine is an incomplete science that can be frustrating if there is not an easy answer.
A little humility and simply saying ‘I believe you but I don’t know what to do to help you and I am sorry that you are ill’ doesn’t take a great deal of effort.”
The art of medicine is a science that we do not yet understand.