BackgroundThe academic and medical literature highlights the positive effects of empathy for patient care. Yet, very little attention has been given to the impact of the requirement for empathy on the physicians themselves and on their emotional wellbeing.DiscussionThe medical profession requires doctors to be both clinically competent and empathetic towards the patients. In practice, accommodating both requirements can be difficult for physicians. The image of the technically skilful, rational, and emotionally detached doctor dominates the profession, and inhibits physicians from engaging (...) emotionally with their patients and their own feelings, which forms the basis for empathy. This inhibition has a negative impact not only on the patients but also on the physicians. The expression of emotions in medical practice is perceived as unprofessional and many doctors learn to supress and ignore their feelings. When facing stressful situations, these physicians are more likely to suffer from depression and burnout than those who engage with and reflect on their feelings. Physicians should be supported in their emotional work, which will help them develop empathy. Methods could include questionnaires that aid self-reflection, and discussion groups with peers and supervisors on emotional experiences. Yet, in order for these methods to work, the negative image associated with the expression of emotions should be questioned. Also, the work conditions of physicians should improve to allow them to make use of these tools.SummaryEmpathy should not only be expected from doctors but should be actively promoted, assisted and cultivated in the medical profession. (shrink)

Burnout is a multidimensional work-related syndrome that is characterized by emotional exhaustion, depersonalization – or cynicism – and diminution of personal accomplishment. Burnout particularly affects physicians. In medicine as well as other professions, burnout occurrence depends on personal, developmental-psychodynamic, professional and environmental factors. Recently, it has been proposed to specifically define burnout in physicians as “pathology of care relationship”. That is, burnout would arise, among the above-mentioned factors, from the specificity of the care relationship as it develops between the physician (...) and the patient. Accordingly, experimental studies and theoretical approaches have suggested that burnout and empathy, which is one of the most important skills in physicians, are closely linked. However, the nature of the relation between burnout and empathy remains not yet understood, as reflected in the variety of theoretical and contradictory hypotheses attempting to causally relate these two phenomena. Firstly, we here question the epistemological problem concerning the modality of the burnout-empathy link. Secondly, we hypothesize that considering the multidimensional features of both burnout and empathy, on one hand, and on the other hand, the distinction between empathy and sympathy enables to overcome these contradictions and, consequently, gives a better understanding of the relationship between burnout and empathy in physicians. Thirdly, we propose that clarifying the link between burnout, empathy and sympathy would enable developing specific training in medical students and continuous professional formation in senior physicians and would potentially contribute to the prevention of burnout in medical care. (shrink)

The academic and medical literature highlights the positive effects of empathy for patient care. Yet, very little attention has been given to the impact of the requirement for empathy on the physicians themsel..

Suffering is an unavoidable reality in health care. Not only are patients and families suffering but also the clinicians who care for them. Commonly the suffering experienced by clinicians is moral in nature, reflecting the increasing complexity of health care, their roles within it, and the expanding range of available interventions. Moral suffering is the anguish experienced in response to various forms of moral adversity including moral harms, wrongs or failures, or unrelieved moral stress. Confronting moral adversity challenges clinicians' integrity: (...) the inner harmony that arises when their essential values and commitments are aligned with their choices and actions. The most studied response to moral adversity is moral distress. The sources and sequelae of moral distress, one type of moral suffering, have been documented among clinicians across specialties. Recent interest has expanded to include a more corrosive form of moral suffering, moral injury. Moral resilience, the capacity to restore or sustain integrity in response to moral adversity, offers a path designing individual and system solutions to address moral suffering. It encompasses capacities aimed at developing self- regulation and self-awareness, buoyancy, moral efficacy, self-stewardship and ultimately personal and relational integrity. Moral resilience has been shown to be a protective resource that reduces the detrimental impact of moral suffering. Clinicians and healthcare organizations must work together to transform moral suffering by cultivating the individual capacities for moral resilience and designing a new architecture to support ethical practice. Used worldwide for scalable and sustainable change, the Conscious Full Spectrum Response, offers a method to solve problems to support integrity, shift patterns that undermine moral resilience and ethical practice, and source the inner potential of clinicians and leaders to produce meaningful and sustainable results that benefit all. (shrink)