Patient Doctor Relationship


For the first time on this blog I wrote a series, yes about patient doctor relationship. It was fun and not easy to stop. You can look at it from very different angles and I did have some more.

The most liked by the “audience” was the first piece on empathy. Now empathy is for most of us confusing. It depends on what definition you use. I discussed it from the view point of a very strict definition as mainly used in psychotherapy. From that point of view I concluded that

Empathy is a quality not every human or doctor possesses. Moreover, experience and age enhance the use of empathy. Not to say that lack of experience or being young excludes the possibility for showing empathy, there are still natural talents out there.

Empathy is mostly confused with sympathy, consolation and emotional contagion. In the next post in this series I discussed consolation and why it is important for us human beings.

Another important topic is can we teach empathy in Med School?
In short: No I don’t think so. For several reasons. Empathy is a process with different steps. Especially feeling what the patients feels is a quality not every doctor has. And if they do it is not always appropriate nor possible to be sensitive enough to use it. Moreover this process not only needs the quality it is also costs energy, depends on the relationship with the patient, and needs experience.

The next post was on Self -disclosure by doctors. One of my favorites. Happily a blogger whom I greatly admire, aqua writing on Vicarious Therapy, shared with us the self disclosure of her pdoc. As can be derived from the post I am not an advocate of self-disclosure.

Sharing strong beliefs or emotions without understanding the patient’s perspective seems risky; a practitioner may unknowingly infuse the dialogue with his or her needs without carefully tying them to the patients’ needs

The neuroscience of empathy was tough.It is still in it’s infancy and like most human emotions hard to understand.

In contrast to empathy, emotional intelligence is an easier concept to handle. You van even measure emotional intelligence. There is also some evidence that higher Emotional Intelligence (EI) in doctors is important to the patient doctor relationship. Assessment of EI is now used as part of the selection process for some medical school applicants in an effort to consider an applicant’s competence in interpersonal skills. Is that a good thing or bad?

Accidentally I bumped in to a nice video and description of emotibots. Through the combination of cameras,sensors, artificial neural networks and software development ICT results are developing robots that can respond to human emotions.

The last post in that series was about Humanism and professionalism. The opinion that humanism and professionalism are one and the same carries the risk of isolating the physician from the lay public. The tension between adapting to a new professional identity and the lay position is most visible and even palpable during clerkship and residency training. To me this topic is very recognizable and new. Really an eye opener.

Well that sums it up. And yes I liked it so much that tomorrow I will start another series about mass media and psychiatry. What do they write about mental illness in newspapers and why is that important. Also gender influences on description of patients in newspapers and how is ECT portrayed in the newspapers. Can’t wait.