Third-grader James likes math and Batman. He often comes home from school to an empty house. Like many children in his Memphis neighborhood and in poor communities across our nation, he is overweight and, even at the age of 8, pre-diabetic. He also suffers from asthma and has to make scary visits to the emergency room a couple of times each year. States Kendra G. Hotz, The Tennesean.
Doreen, a young Medicare recipient, tells me that when she goes to a typical doctor’s office, she is treated like she’s dirty because she is poor, yet when she goes to a certain community clinic that she has come to trust, she is treated like a queen.
Brenda, who cleans homes and serves as a caregiver for a few elderly Memphis residents, was labeled “non-compliant” when she didn’t take her potassium supplement as prescribed. In reality, she could not afford the supplement, so she searched for food with the highest potassium content.
Ask a group of medical students or residents what the prospects are for a healthy life for James, Doreen and Brenda, and they’ll likely tell you that they are on track for a lifetime of expensive medical care, chronic pain and even shortened life expectancy. They would ask why these patients don’t eat better and exercise more, trust in medical experts or follow doctor’s orders.
America has great doctors, hospitals and medical research facilities, but not everyone benefits equally. The poor and racial and ethnic minorities suffer from health disparities, and this can be attributed in part to unconscious bias on the part of health-care providers. Health-care providers also fail to form empathetic connections to patients who are different from themselves, and this can exacerbate those disparities.
A number of studies show that empathy, the ability to understand and appreciate patients’ emotional needs, is associated with improved health outcomes, especially when it comes to following a plan of care. Doctors who lack empathy become judgmental and do not not try to not understand the economic challenges the poor face. Instead, they write “non-compliant” on Brenda’s chart, and that label gets passed on to others.
The good news is that empathy can be learned, practiced and improved upon. We have to do better at integrating this critical skill into the medical profession. The Jefferson Scale of Physician Empathy (JSPE) measures empathy among students and physicians, and it shows that men and women lose empathy during medical school. Women do display slightly higher empathy levels than men.
A study at Robert Wood Johnson Medical School found that empathy training with medical students could prevent the drop in empathy that we usually see in the third year of medical school.
What does this new field of empathy training look like? An example is a collaboration with the Rocking Chair Project by Jefferson’s Sidney Kimmel Medical College, where students deliver and assemble rocking chairs in the homes of indigent mothers of newborn babies.
Nia Zalamea, a general surgeon, and I have recently developed an online course on creating equitable relationships between patients and providers for The Institute for Healthcare Improvement’s Open School, and there are many more efforts underway.
To be sure, there are social structures that deny robust life chances to many, and medical institutions were not designed to solve social problems. Health disparities will only be overcome completely when we make policy and structural changes in the form of zoning laws, transit and educational systems and more. But while we work for these changes, empathy can go a long way toward creating a more just health-care system for James, Doreen and Brenda.
Here in England with our great NHS C&C Empathy Training provide specialised training to empower health and social care professionals to safeguard well-being and prevent prolonged psychological harm (Duty of Candour) to both service users and staff within the complaints and Serious Incident system and in all communication settings.
The therapeutic relationship between clinician and patient, the 6 C’s within nursing and preventing psychological harm within complaints are all underpinned with empathy and emotional development skills.
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A one-day course to develop a deeper level of communication to approach difficult and sensitive conversations with patients, families and other members of staff with empathy. Delegates will develop psychological understanding and essential skills to best communicate with compassion and confidence. The training includes self-awareness and reflection skills in line with the latest NMC revalidation requirements.
A one-day course for ideal for those working with families raising an initial concern or following the official complaints procedure. Delegates will develop the confidence to handle such conversations with empathy, understanding and consistency to reach a meaningful resolution and help to minimise conflict. Prevention of prolonged psychological harm is embedded throughout this thought provoking day.
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