Opinion | Empathy: A Path to Healthier Healthcare

Even as the country creeps slowly toward a long-anticipated “new normal,” I’m unable to shake off my concern about the pandemic’s long-term toll on physicians, healthcare professionals, and others employed in the healthcare sector.

In the midst of these winter doldrums, I had an interesting and surprisingly upbeat conversation with Helen Riess, MD, a psychiatrist and medical educator at Massachusetts General Hospital and Harvard Medical School. Well before the arrival of COVID-19 and the socio-political polarization that intensified in its wake, Riess became concerned about the dearth of empathy in medical training and clinical practice. This led to a career-transforming focus the neuroscience and practical application of empathy.

Perhaps because it requires one individual to understand another’s feelings, empathy is often assumed to be an innate ability — “Some have it and others don’t.” Contrary to this conventional wisdom, Riess’s research reveals a neurobiological basis for empathy and demonstrates that it can be learned and taught with the aid of evidence-based interventions.

Echoing the concerns I raised above, Riess observed that the decisions and choices of disparate groups have led to unsubstantiated claims, outrage, and politicization of health care. “Once buoyed by a belief in the common good, healthcare workers are now faced with making moral compromises in an atmosphere charged with anxiety and fear.” This “toxic brew” has led to the unprecedented physical demands and exhaustion experienced in the healthcare sector today.

Managing patients’ failure to act in their own best interest is not new to medical practice, but today’s already burdened healthcare workers are confronted with vaccine resistance among those for whom they must provide optimal care. “Burnout has been a persistent problem for healthcare workers for decades; the pandemic coupled with a loss of public confidence in the healthcare system has ripped the band-aid off!”

Given such a bleak picture, I asked Riess how she remains genuinely hopeful and cautiously optimistic.

Despite the suffering everyone has endured, Riess believes that the crisis opened up unique opportunities to begin creating a more “human” healthcare system – one built on institutional empathy with training for healthcare workers and leaders alike. “Physicians and other healthcare professionals need to develop the skills necessary for sitting down with patients and understanding the needs that influence their decisions and choices — without judgement. It requires more than ‘being nice’.” In effect, the perception of empathy in medical and healthcare professional training should be reframed from “soft skill” to neurobiological competency.

Healing is imperative for caregivers – especially for those who have been on the front lines and bearing enormous emotional burdens. Neurobiology-based e-learning and in-person training has been shown to increase empathy. In addition to helping themselves, empathetic skills help caregivers “meet patients with hope rather than confrontation, annoyance, and blame.”

Although empathy is ordinarily considered to be a two-person dynamic, Riess believes that empathy can be elevated to a system-wide dynamic when leaders institute policies to ensure that they and their employees receive training. She also strongly endorses a practice of “self-empathy” to combat the epidemic of burnout among healthcare workers, training for which she has developed. Noting that compassion already figures prominently in institutional mission statements, she suggests, “Begin by asking, ‘What kind of system would I want to work in?'”

Reflecting on this conversation, I asked myself that very question. I envisioned a healthcare system in which all healthcare professionals (myself included), leaders, and other workers were trained and competent in empathy. Might understanding the reasons for patients’ decisions and behaviors lead to more effective care management? In a broader sense, might empathetic interactions with patients and the public eventually help restore faith in the healthcare system?