Whether during a surgery, biopsy, physical exam, or even a simple blood draw, healthcare professionals routinely must inflict pain on others to make them better in the long run. Physicians also need to have daily communication with patients who are physically injured, bleeding or otherwise suffering. Being too focused on the patient’s pain can make the doctor less effective. Suppressing the response to others’ pain may in fact free up information processing resources to more effectively solve clinical problems. This argument explains the finding that physicians get less empathic as they see more patients and progress through their training. In addition, a recent study of hospital nurses found that they cope with stress on the job by dehumanizing patients, which presumably makes them more effective at their jobs.
Despite these findings, there can be no doubt that empathy is crucial to a successful healthcare system. Empathy is invaluable for motivating the whole process of delivering care, for ensuring effective communication (who wants to talk about embarrassing symptoms to a frigid doc?), and for building long-term relationships of trust between doctors and patients.
The job of any physician is therefore part empathic and part problem solving. This constitutes an inherent trade-off in medicine because the human brain does not have infinite computational resources or time to perform both tasks equally well. One must be caring while also figuring out a proper diagnosis, prognosis and treatment, often under conditions of uncertainty.
Just as only using one’s cognitive problem-solving skills would not necessarily lead to the best outcomes for patients, only employing one’s empathic and emotional skills doesn’t lead to the best outcomes, either. Empathy is not an inherent good in medical care, but a relative one. As with deliberative reflection and abstraction, empathy is also useful only in certain degrees and in certain contexts, but can be unproductive or destructive in others. A surgeon, for instance, should be highly empathic when discussing surgical options with an upset patient, but will need to regulate empathy during the surgery.
The key is knowing when empathy is called for and when it is detrimental. It should not be the goal of physicians, then, to be more empathetic. They should aim instead to find the right balance, the golden mean that optimizes care.
Are you a scientist? And have you recently read a peer-reviewed paper that you would like to write about? Please send suggestions to Mind Matters editor Gareth Cook, a Pulitzer prize-winning journalist at the Boston Globe. He can be reached at garethideas AT gmail.com or Twitter @garethideas.