Clinical empathy

Clinical empathy is expressed as the skill of understanding what a patient says and feels, and effectively communicating this understanding to the patient. The opposite of clinical empathy is clinical detachment. Detached concern, or clinical detachment, is the ability to distance oneself from the patient in order to serve the patient from an objective standpoint. For physicians to maximize their role as providers, a balance must be developed between clinical detachment and clinical empathy.

In 2001, an instrument was created to measure a physician's empathy towards each patient. This tool is called the Jefferson Scale of Physician Empathy. The 20-item questionnaire was originally developed for administration to medical students and physicians but has extended to dentistry and nursing because it is easy to interpret, administer, and analyze.

From a student's first year to their fourth year in medical school, empathy scores on the Jefferson Scale of Physician Empathy (S-version) decrease. Both gender and specialty choice affect empathy scores, favoring women and primary care specialties.

Clinical empathy is a main component of the patient-provider relationship. It is seen as a commonly accepted pillar of professionalism for medical students. Empathy involves both cognitive and affective aspects. The cognitive domain revolves around understanding a patient's experiences and being able to understand the world from their point of view. This contrasts the affective aspect of empathy which involves joining in the patient's emotional experiences and feelings, which correlates closer to sympathy. Empathetic physicians share understanding with patients, which serves to benefit the patient in their physical, mental and social well-being. Both a provider's ability to provide empathetic care as well as a perception of this care by the patient are important in diagnosis and treatment. Developing the ability to understand a patient's thoughts and feelings lends itself to a successful medical interview and collaborative treatment. Practicing empathy in a clinical setting leads to greater patient satisfaction, better compliance, and fewer lawsuits.

Clinical detachment is a means of providing objective, detached medical care while maintaining enough concern for the patient to offer emotional understanding. A close patient-provider relationship threatens objectivity, therefore a social distance is expected to ensure professionalism. Students in medical school are taught clinical detachment as a protective mechanism for dealing with emotional experiences such as death and dying. Clinical detachment is also a means of dealing with the pressure of making mistakes and medical uncertainty. Suppression and repression of emotions, intellectualization, and humor are mechanisms used to confront distressing situations in order to give an objective assessment.

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