Leading with Empathy

In our everyday lives, our perceptions of the people we interact with are shaped by subtle and not so subtle cues – facial  expressions, tone of voice, body language. The sum total of these cues defines our experience.

Consider my recent interaction with a store manager at a Dunkin Donuts. I ordered a coffee using their app and when I got to the mobile orders pick-up shelf, I didn’t see my name on any of the cups, so I politely asked about it. The manager approached and asked me, “Have a name?” I gave her my name, and she went to the prep area and found it – noting that the order came in as a drive-through versus a pick-up. I apologized for the confusion, and she responded, “That’s OK.”


Just looking at the words in this exchange makes it seem as if it was a positive interaction. But the manager’s facial expressions and body language conveyed anything but.

  • She never made eye contact with me.
  • Her facial expression suggested irritation. And, she moved quickly and aggressively between the prep area, the lobby, and the counter without stopping or pausing when speaking to me.
  • Her words said one thing, while her behavior said the opposite.

While picking up coffee doesn’t typically have life-altering consequences, interactions in a healthcare environment can.

The strains of today’s healthcare environment can push physicians and other caregivers to their emotional edge. Physician leaders bear the additional responsibility of role-modeling empathy when working with others. If a leader is to influence others, they must be able to successfully regulate their own emotions. In fact, neurobiology predisposes us to prefer leaders who, above all else, express empathy and compassion, according to Dr. Helen Riess.

I’m currently coaching physician leaders on using empathy to improve their working relationships with colleagues. The engagement materialized due to some complaints from physician peers and nursing staff. Together, we uncovered that their words didn’t generate the friction, but rather the tone of voice, body posture, facial expressions, and lack of active listening to fully understand and acknowledge the other’s perspective.

These physicians are now practicing the art of slowing down and neutralizing their negative thoughts before entering a conversation. Sometimes this means they don’t speak at all at the moment. They just listen and come back later to share their perspective, most often in a one-on-one conversation rather than a group setting.

More effort? Absolutely! Time-consuming? For sure! But is it more time-consuming to have more positive exchanges or to repair damaged interactions?

What Empathy Means

Dr. Helen Riess is a psychiatrist at Massachusetts General Hospital and author of The Empathy Effect. In her TED Talk, she emphasizes that lack of empathy has consequences. “Patients who ‘don’t feel cared about’ have longer recovery rates and poorer immune function,” she says.

Dr. Riess recognizes that physicians, nurses, and other caregivers struggle with consistently demonstrating empathy while wrestling with the growing demands on healthcare providers. To address this, she has developed an empathy training program specifically for physicians, nurses, and others providing direct patient care.

She uses the acronym E. M. P. A. T. H. Y. to describe the ways providers can show empathy:

  • E is for eye contact. Dr. Riess recommends looking into the other person’s eyes long enough to identify their eye color.
  • M is for muscles of facial expression. The brain is wired to mimic ‘others’ facial expressions and facial expressions can trigger emotions. Thus, the importance of working facial expressions so they convey the emotions you want to convey, and you want others to feel.
  • P is for posture, which is as much an indicator of an emotional state as facial expressions. When working with patients, she sits facing them directly, leans forward, and sits at eye level. If she finds herself sitting with crossed arms, she checks in with herself to see what she is feeling and adjusts as needed.
  • A is for affect, which Dr. Riess suggests is the same as emotion. When sitting with a patient, she recommends that physicians name the affect they see. Interpret what the person is feeling and be aware that their affect may trigger their own emotions.
  • T is for tone of voice. Match the volume and pace of the person you were trying to connect with. But if the person communicates loudly and frustratedly, then speak more softly and slowly.
  • H is for hearing the whole person. Try to understand the other person’s perspective first, then try to communicate yours. Set aside your own emotions to listen with openness. The challenge for physicians and other caregivers is to distinguish between the patient’s chief complaint versus their chief concern.
  • Y represents your response. Paying attention to how you feel when you’re in the other person’s presence is essential. Whether recognized or not, you will resonate with the feelings of others.

I coach physicians and healthcare administrative leaders on how others perceive them. Email me at amccarthy@barlowmccarthy.com for a copy of my two-page summary of Dr. Riess’s seven keys. Watch her TED Talk here and learn more about the neurobiology and physiology of empathy.

Read the original article in Barlow/McCarthy’s newsletter