Cancer doctors lack empathy for patients

Thursday, November 03, 2011 by: S. L. Baker, features writer
Tags: oncologists, empathy, health news

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(NaturalNews) Treating cancer patients, who are suffering excruciating side effects from radiation and chemotherapy, is emotionally draining. But wouldn't you think someone who chose the profession of oncology would know this in advance and would have a lot of compassion for his or her patients? It turns out, that's not exactly true for many oncologists.

"Earlier studies have shown that oncologists respond to patient distress with empathy only about a quarter of the time," James A. Tulsky, M.D., director of the Duke Center for Palliative Care, said in a media statement. "Often, when patients bring up their worries, doctors change the subject or focus on the medical treatment, rather than the emotional concern. Unfortunately, this behavior sends the message, 'This is not what we're here to talk about.'"

In a new study just published in the Annals of Internal Medicine, Dr. Tulsky and his research team found that the use of a computer-based interactive training tool developed by Dr. Tulskey resulted in more empathic responses from oncologists. After the cancer doctors incorporated techniques they learned from the computerized training, their patients reported greater trust in their doctors which translated into a better quality of life for the cancer patients.

To test the new computer training's effectiveness, Dr. Tulsky and colleagues enrolled 48 doctors at Duke, the Veterans Affairs Medical Center in Durham, N.C., and the University of Pittsburgh Medical Center. They audio-recorded four to eight visits between the doctors and patients suffering from advanced cancer.

All the physicians then attended an hour-long lecture on communication skills. Next, half were randomly assigned to use the CD-ROM tutorial to learn empathy skills and the other half received no other training. The results of the study showed the CD taught the doctors how to recognize and respond when patients shared a negative emotion and how to communicate information about prognoses. They also received feedback on how they could improve their communication with cancer patients and were asked to commit to making changes in their practice to demonstrate more empathy.

Afterward, all the doctors were again recorded during patient visits and then both trained listeners and patients were asked to evaluate how well the doctors responded with empathy when faced with patient fears and questions. Oncologists who had taken the CD course responded empathetically twice as often as those with no training. They were also more like to promote conversations rather than to shut them down when patients tried to talk about concerns.

"Patient trust in physicians increased significantly," Dr. Tulsky said in the media statement. He explained that patients actually feel better when they believe their doctors are on their side. "This is exciting, because it's an easy, relatively inexpensive way to train physicians to respond the basic needs of a patient."

Learning empathy skills is "too expensive" and time consuming

In a press statement, Dr. Tulsky said the problem with oncologists not being empathetic is not that the doctors are uncaring, it's just that communication needs to be taught and learned." He then pointed out that the current gold standard for teaching oncologists empathy skills is a multi-day course that involves short lectures and role-playing with actors hired to simulate clinical situations.

The drawback is that these courses take up the doctors valuable time and are expensive, costing around $3,000 per physician. Dr. Tulsky's computer program, however, lets doctors complete empathy training in their offices or homes in a little more than an hour and at a cost of only about $100.

These factoids raise a couple of troublesome issues. First, why do so many physicians seem to lack the ability to express empathy, and to communicate in a caring way when seeing seriously ill patients? And, second, how can a $3,000 tax deductible course that teaches empathy skills be considered "too expensive" for oncologists? After all, these physicians typically make huge salaries. According to a report from the Medical Group Management Association, oncologists rank among the highest paying physician specialists, raking in about $ 500,000 a year.

The new CD course is not yet widely available to train oncologists on how to be more empathetic with patients, but Dr. Tulsky said efforts are underway to develop it for broader distribution.

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