April 12, 2024

Training more empathetic doctors

Patients often complain that new doctors lack empathy. What’s the solution?

Patients often complain that freshly-minted doctors lack empathy. But what’s the solution?

A recent comment in the New England Journal of Medicine considers this question, and offers some novel suggestions. 

Dr. Richard M. Schwartzstein of Harvard Medical School doubts that the dearth in empathic graduates is  simply the result of lax admissions criteria in med schools:

 “I believe that the causes of current problems in doctor–patient interactions are more complicated than this… we should question the assumption that we’re admitting the wrong students — and consider alternative solutions…”

Schwartzstein argues there are systemic problems in the way universities teach medicine:

“Typically, students enter medical school idealistic, eager to improve the human condition, and excited about becoming doctors. And then we do various things to change them. We have them memorize long lists of facts (or at least they perceive that as our goal), delay their involvement with patients, and expose them to frustrated and overwhelmed faculty members who are under increasing pressure to generate greater clinical revenue. And students’ empathy diminishes.”

He proposes a number of bold solutions that he believes will improve interactions between doctors and patients.

“First, we can explicitly celebrate and support the idealism, kindness, and patient focus with which students enter medical school… Second, we can ensure that the clinical faculty who supervise our students are selected for, and trained to enhance, their ability to support rather than undermine these values…

“Third, we can continue to refine objective measures and instruments that enable faculty to assess interpersonal skills, provide faculty development to ensure these assessments are completed, and prohibit students deficient in the skills necessary for patient-centered care from advancing in their training…”

Schwartzstein’s suggestions may sound nebulous, but they seem to resonate with the experience of young medical students.

Ilana Yurkiewicz, a fourth year student in Harvard Medical School, recently lamented a loss of empathy and creativity among students in hospital wards:

“As a third and fourth-year medical student, I sometimes felt like a dolt on the wards… the most negative experiences for me weren’t the result of any particular individual, but a culture that treated me in certain ways – that set certain expectations for who a medical student was and how she should be treated, and then acted to mold me toward those expectations…”

Like Schwartzstein, Yurkiewicz suggests a change in approach among medical professionals charged with forming the next generation of doctors:

“I want our patients to be at the center of everything we do. I want an environment where people feel comfortable being themselves and are free to ask questions, have emotions, and disagree with those more experienced. I want the focus to be on education over evaluation.”

Training more empathetic doctors
Xavier Symons
Creative commons
doctor-patient relationship
medical school
patient care
professional conduct
virtue ethics