Is Compassion Missing From the Medical Curriculum?

ATLANTA, Georgia — As outlined in the Principles of Medical Ethics of the American Medical Association, physicians should demonstrate compassion and respect for human rights.¹  Compassion, empathy, and sympathy are emotions necessary in the delivery of ethical medical care.  However, in a healthcare environment that is moving toward being more technical and business-focused, it is becoming increasingly difficult for clinicians to balance the business of practicing medicine with the humanistic needs of their patients. In addition, the persistent indiscriminate use of insensitive and inappropriate language can undermine the physician/patient relationship.

To this end, a team of clinicians from the Center for Medical Ethics and Health Policy at Baylor College of Medicine, in Houston, Texas, and Sutter Health/California Pacific Medical Center, in San Francisco, California, conducted a review of empathy in medical training.  Their study was presented at the 2016 Annual Meeting of the American Psychiatric Association (APA), in Atlanta, Georgia.

The authors posit that language frames how clinicians think about patients and how patients think about themselves.  When used in an empathic fashion, language can help to promote beneficial relationships and improve outcomes.  However, despite a movement toward promoting humanism in medical education, students continue to experience unethical behavior during training.

The authors cite research that the mental and emotional health of medical students starts to deteriorate upon entry into medical school and remains poor throughout training; medical students’ empathy also declines during this learning period. However, they propose that additions to the medical curriculum that promote mindfulness and compassion may serve to mitigate against the damaging effects of burnout, derogatory language, and exposure to behaviors that contradict the moral and ethical values inherent in the practice of medicine.

Person-first language is one technique that emphasizes using words to reflect positive attitudes toward people with illnesses and/or disabilities. The phenomenological empathy of dialectical behavioral therapy proposes that clinicians nonjudgmentally accommodate the experiences and perceptions of their patients. Mindful self-compassion encourages the use of kindness rather than judgment when presented with mistakes and failure, thus increasing relationship functioning and empathetic concern. Mindfulness-based stress reduction serves to reduce stress by increasing awareness of negative thought patterns.

The authors propose that implementation of these techniques into medical training programs, combined with exposure of medical students to appropriate patient-focused language, will result in more meaningful patient encounters and improved patient outcomes.  

Click here for more research from the 2016 Annual Meeting of the American Psychiatric Association.

Reference

Conrad R, McGuire Am, Springer J, Martin C. The compassion crisis in medical education. Poster presentation at: 2016 Annual Meeting of the American Psychiatric Association; May 14-18, 2016; Atlanta, GA. P2-022.