Bioethics Discussion Blog: Should Doctors Cry? (1)

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Wednesday, March 02, 2005

Should Doctors Cry? (1)

Go to retired doc's thoughts where James writes his views of the article in the March 2, 2005 issue of JAMA by E.B. Larson and X. Yao who suggested that method acting be part of the training and use by physicians in creating effective empathy in the patient-doctor relationship. I wrote a comment there but I also wanted to extend the issue a bit here on my blog.

One of the emotional issues which my first year medical students experience and are concerned about is what should they do if the story related by the patient in the bed in front of them is causing the student to feel so sad that tears are welling up in the student's eyes. They ask because they have experinced this reaction. The students ask me "should doctors cry?"

In view of the article, the question arises should doctors be actors and train to supress any emotional unsupportive response on their part whether sadness or anger or any form of irritability? And in the other direction, should they act fresh, composed, in tip-top mental and physical condition, happy and encouraging even when the doctor feels just the opposite? After all, shouldn't the doctor always be therapeutic in their behavior to the patient and wouldn't showing the wrong emotion be not helpful for the patient?

Before I go on any further, I would like to read the views of my visitors, both as a patient or as a physician, on this subject. ..Maurice.

3 Comments:

At Thursday, March 03, 2005 1:02:00 PM, Blogger Bioethics Dude said...

Hmmm...Naturally, I will only comment on this as a patient and an observer when in the presence of friends/family members who were patients: 1) Doctors should be empathetic. I think showing that a doctor relates or somehow at least tries to understand the mental state of the patient would provide the patient a sense of calmness/coping. It would show that the one coming up with a diagnosis understand the repercussion of that or the disease. I know that doctors do, don't get me wrong, but I think that patients tend only to see the scientifically reached conclusion. 2) I don't think that doctors should show great levels of either negative or positive emotion. I see showing the types of emotion you mentioned though, as being different than the empathy I describe above. Personally, if Bioethics Dude's doc showed irritability/joy I would first wonder if it's directed at the Dude, or at something related to the illness (e.g., medicine, administration, etc.). I'd hate to have it be directed at the Dude, unless perhaps it'a question of adherence...

 
At Thursday, March 03, 2005 7:22:00 PM, Blogger Maurice Bernstein, M.D. said...

Improving patient compliance with the medical regimen is one of the benefits developed through empathy. By connecting to the patient, the physician understands better to intentions, values and goals of the patient and can anticipate problems of compliance before they occur. Also the physician may be able to direct and formulate information about the treatment for the specific patient by this understanding. For example, patients might have a priority in spending their monsy and may feel that a purchase of a recommended drug doesn't meet that priority compared to other essential needs. Making a connection with the patient thru empathatic communication may alert the physician to this issue and the recommendation might be expressed in another but more effective way. ..Maurice.

 
At Tuesday, April 29, 2008 8:31:00 PM, Blogger Maurice Bernstein, M.D. said...

You may find the article "At Bedside, Stay Stoic or Display Emotions?" in he April 22, 2008 New York Times by physician Barron H. Lerner of interest regarding the topic of this thread. ..Maurice.

 

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