Empathy in General Practice - a personal (and evidence-based) viewRob Walker - 18 Oct, 2018
Empathy is a subject I’ve taken more interest in over the past few years. I took my daughter to an exhibition ‘A Mile in my Shoes’ on the Southbank a couple of years ago. In the giant ‘shoe box’ are a series of shoes donated by local people and you physically put their shoes on and go for a walk while listening to an audio of the story of their life that has been pre-recorded. I listened to a fascinating insight into the life of a local palliative care consultant, while my daughter had her eyes opened by listening to the story of a young boy recently arrived in London as a refugee.
Anyway, what has this got to do with General Practice? Ever since that experience, I have been more aware of the importance of empathy in the consulting room and there were two articles in the September 2018 BJGP that caught my eye - one a cross-sectional study from the Netherlands looking at the difference in how GPs and patients scored the GPs ability to empathise; the second was an editorial exploring the meaning and importance of empathy in General Practice.
There is still no universally accepted definition of empathy but the one I most like suggests that empathy is the ‘art of stepping imaginatively into the shoes of another person, understanding their feelings and perspectives, and using that understanding to guide your actions’. I think that encompasses nicely what we are doing in a consultation when trying to connect with our patients. Empathising with patients is a key part of forming a therapeutic relationship and a systematic review in 2013 concluded that ‘There is a good correlation between physician empathy and patient satisfaction and a direct positive relationship with strengthening patient enablement. Empathy lowers patients’ anxiety and distress and delivers significantly better clinical outcomes’.
Evidence consistently shows that patients rate doctors highly in terms of empathy. But what is our perception as to how well we empathise with our patients? The study in this BJGP interestingly showed that patients consistently scored the doctors better at empathising than the doctors did. So why do we not think we are doing as good a job as we’re actually doing? Is it all the negative messages about GPs, General Practice and the NHS in general? We may not be able to metaphorically step into our patients shoes and go for a 20-30 minute walk with them in our consultations, but the evidence would suggest that despite all the pressures we are under, our ability to step into our patients shoes and empathise with them is still good. In the constant drive for more efficiency in the NHS, this message must not get lost: empathy is a crucial aspect of the therapeutic relationship in General Practice, it delivers better patient outcomes, and primary care is still doing a great job in this regard.
And finally, where does NB Medical fit in with all of this? Yes, we are here to do all that reading and condensing of the literature to keep you up to date with all the latest research and guidelines, but as we always say on our courses that is only part of the story. YOU are the experts in delivering care to YOUR patients. Learning to walk in your patients’ shoes can be one of the most powerful and therapeutic ways to do this.