How Physicians Learn Empathy to Improve Cancer Care

Dr. Dieter sits with a cancer patient at the hospice.
Dr. Dieter sits with a cancer patient at the hospice.
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Laurie Merges had just gotten out of the shower when she got the call that she had breast cancer. She told her story to other cancer patients at a meeting arranged by ideastream and the Gathering Place, a cancer support center.

“I have three young children, a ten-year-old and two five-year-olds," Merges said. "And they were downstairs playing, it was Christmas break. And she said it was cancer, and I just literally was laying on the floor in the fetal position crying. Like what am I going to tell my children? They’re downstairs. And mom has cancer.”

For most patients like Merges, a cancer diagnosis can mean difficulties in coping with the overwhelming emotions. It’s why some doctors believe the notion of empathy, or being in tune with a patient’s emotions and suffering, has to play just as large a role in cancer diagnosis and care as the clinical, data-driven treatment side.

Dr. Anthony Back runs VitalTalk, a website that trains physicians on communication skills. He notes that a 2010 study found that a patient’s quality of life and even outcome may be improved when empathy and improved communication are involved.

“The group that had the special communication, you know every 3 weeks for the entire course of their cancer – they had less depression, they had less anxiety, they had better symptom control because they were managing their symptoms better. They actually lived a little longer,” Back said.

Dr. Kevin Dieter, a palliative care doctor with Hospice of the Western Reserve, is a firm believer in “sitting in a patient’s suffering” with them. But he also knows that exposure to constant suffering can lead to physician burnout.

Experts are now saying that burnout can have a negative impact on cancer care. Dieter notes in order to combat that, doctors have to take care of themselves first.

"So really the focus should be, and it’s starting to be this in medical schools and residency programs, is we pay attention to the things that will make them less compassionate and try to protect against that, but we also want to encourage things that will develop resiliency," said Dieter.

That’s what’s happening here at this Cleveland Clinic empathy training session, where physicians and med students are being trained to build that resilience and nurture compassion.

"What are you feeling from him, what can you palpate from him from your chair," said the instructor.

"Fear," the student playing a doctor said.

"He’s scared. So, address it. Because if he’s in fear it’s going to be very hard for him to move out of that and tell you more detail. And we’ll just restart. Showing fear."

"So I’m sensing frustration and fear."

"Yeah. I don’t wanna die."

The students are learning how to gather emotional information from the patient, which in turn will help them break bad news and navigate the patient’s care, says Dr. Katie Neuendorf, a facilitator of the training program.

"I think about this in the world of cancer in particular, how we deliver bad news to our patients really affects their ability to process that information," said Neuendorf. "It will affect them in terms of depression, and it will affect how they take that information and plan for next steps."

Even 10 years ago, empathy training wasn’t a part of a young doctor’s education. But Neuendorf hopes that with a little self-awareness, practice, and a curriculum that teaches empathy, the newest generation will be a little more in tune with their compassionate sides.

 

Cancer and Empathy Resources

NIH

CancerCare

National Coalition for Cancer Survivorship

Schwartz Center

The Gathering Place

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