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Maintaining empathy in increasingly guideline-driven general practice settings

Data recently published in the British Journal of General Practice offered solutions for general practitioners struggling to find a balance between “task-oriented communication” with patients and showing empathy and listening.

“As a result of protocol-based guidelines, daily practice has become increasingly technical and somatically oriented. A biomedical mainstream of care may be life-saving and health-promoting, but it risks neglecting the patient’s experiences of illness; understanding this is essential to ensure shared decision making based on the individual patient’s perspective, preferences and needs, and contributes to effective health care,” Frans AWM Derksen, GP, of the department of primary and community care, Radboud University Medical Center, the Netherlands, and colleagues wrote. “The effectiveness of empathy on specific clinical outcomes for patients has been widely proven and [general practitioners (GP)] view empathy as an important element during consultations.”

Previous studies have only examined the issue theoretically or looked at it from the perspective of a hospital specialist, medical educator or GP trainee, researchers wrote. Derksen and colleagues interviewed 30 GPs to identify obstacles to empathy in practice, as well as possible solutions.

The first obstacle covered GPs who felt constrained by time and a need for personal space. To address this conflict, the GPs interviewed would try to adjust the length of an appointment based on a patient’s need or with a professional assistant’s insight. Some even reduced their patient roster.

The second obstacle addressed GPs whose patients’ behavior potentially limited the effectiveness of their communication. Study participants indicated honest and open dialogue helped in these situations.

The third obstacle was maintaining a level of professionalism without getting too emotionally involved. GPs interviewed suggested peer counselling groups, or, when with the patient, acting professionally and setting clear limits on conversations.

The final obstacle researchers addressed was GPs trying to do their job with an ever-increasing set of rules and guidelines while not trying to come across as being solely focused on meeting these standards. The participants suggested both GPs and patients show mutual respect for the other’s knowledge and what each contributes to the decision making process. 

“…[T]his study highlights that empathy helps GPs to consider patients as so-called cooperating experts, an approach with shared responsibility and expertise, enabling tailor-made solutions,” Derksen and colleagues wrote. “This balance is necessary to remain connected with patients and to deliver care that is truly personal.”  – by Janel Miller

Disclosure: The authors report no relevant financial disclosures.