Medical school seems to have a profound negative effect on empathy according to a research review just published in Academic Medicine.
The review of 18 studies found that self-reported emotional understanding declines markedly during medical training. Counter-intuitively, the crucial downturn happens when medical students start seeing patients.
Although the studies are almost completely based on self-report, at the very least they show a decline in being interested in others’ emotional states, even if we can’t be sure that emotional competency is being affected.
Apart from the start of clinical practice phase of training the other major influence in empathy decline was personal distress, which concurs with studies that suggest that people in general report less empathy as they feel worse.
Of course, there may be a number of other factors at work, including the stress of training, an attempt to cope with suffering patients and what the article describes as ‘poor role models’.
What this refers to is the traditional ‘learning through humiliation’ style of medical teaching that seems to be oddly prized by the medical establishment as a form of clinical hazing.
The occasional reply to concerns about physician empathy is usually something along the lines of “what would you prefer, someone who is a good clinician or someone who is a nice person?”.
Despite the false dichotomy, the study make it abundantly clear why empathy is important in medicine, as it is associated with:
• patients’ reporting more about their symptoms and concerns
• physicians’ increased diagnostic accuracy
• patients’ receiving more illness-specific information
• patients’ increased participation and education
• patients’ increased compliance and satisfaction
• patients’ greater enablement
• patients’ reduced emotional distress and increased quality of life