Empathy Can Be Taught?

Response to Dr. Pauline Chen’s “The hidden curriculum of medical schools”

I am skeptical about empathy being taught. I mean real empathy, not the superficial kind that may be mimicked just to please a professor. It is more likely that empathy is learned in childhood from one’s parents or relatives. It may even be genetically related. But, who can say for sure?

The empathy I see is the perfunctory variety tossed off by saying hello when entering patients’ rooms or calling them by their first names. It has some value but patients can tell if it is genuine and if their physicians are truly connecting and concerned.

Taking courses in the humanities is helpful for expanding one’s critical faculties and studying great poetry or novels may give insights into patient’s inner turmoil, but whether they can teach students to actually embrace empathy as healers and make it a permanent addition to their medical skills for the rest of their careers is questionable. The seeds of empathy can be sown but unless the ground is fertile, its roots will be weak.

Unfortunately whether empathy can be taught or not, many difficulties obstruct its being applied effectively. Doctors today are constantly distracted by a stream of little interruptions throughout the day. Any single interruption is minor but collectively they form a tsunami of distraction. Most doctors find them overwhelming and exhausting. Day and night, their fax machines are spewing lab reports, CAT scans, pharmacy requests; visiting nurse forms and home health agency forms—all of which need to be reviewed and either signed and faxed back or acted on by calling a patient or ordering a confirmatory test. Not to mention the many phone calls from patients that must be answered.

Exercising empathy in a suffocating environment like this would be a challenge even for a saint.
When teaching empathy medical school and residency educators should tell the students the obstacles that they will face in private practice that discourage empathy. Eliminating the multitudinous distractions that make medicine almost impossible to practice humanely is one important way to assure the survival of empathy in medicine.

Ed Volpintesta MD