Teaching Empathy

Physicians and other providers struggle to demonstrate empathy given the growing healthcare system demands. But this is a critical skill for physicians to give patients their “best.” Physician leaders are responsible for role-modeling empathy when working with others and helping medical students and residents learn this early in their education and training.

This need for a combination of clinical expertise and empathy skills was recently intensified for me by a physician colleague and friend who now faces stage 4 lung cancer.

With extensive experience in clinical practice as an internist and geriatrician, James Fanale, MD also has a solid leadership background, having been a chief resident, becoming a group practice leader, holding executive positions within BCBS and a community hospital, developing a high-performing ACO, and ultimately, becoming CEO of a three-hospital system in Providence, RI.

While leading his $1.2 billion organization and simultaneously working on a potential merger with another RI-based health system, he developed a nagging cough. By nature, Dr Fanale is a very “matter-of-fact” individual. His modus operand is “getting stuff done.”  So, having no other significant symptoms, it’s no surprise that he focused on his leadership agenda while intermittently going through the “typical” treatment approach. As other minor symptoms came to fruition, i.e., nonspecific headaches (who wouldn’t when facing those professional challenges?), MRI and CT scans ultimately uncovered a lower right lobe lung mass.

To say he was shocked and devastated would be an understatement. Nearly two years into this experience, Dr. Fanale shares his story in Onward: A Teaching and a Love Story – For Physicians And Everyone.

“This experience has taught me that, although I thought I was an expert clinician and had seen everything in my career, I clearly did not understand what patients with these types of illnesses go through. How unprepared we were, and how awful I felt because I kept thinking back to my patients in a similar situation and how I missed opportunities to say certain things and make them feel seen and understood beyond the clinical answers in which I was such an expert. No one ever taught us what our patients go through, and this book aims to demonstrate what it takes and, hopefully, instruct others on how to deal with the situation.”

Where in medical school or residency are physicians trained to understand the inner turmoil that these patients face? Once they complete training, their practices put so much emphasis on productivity, accessibility, and financial stability that there is limited attention to what patients face.

Have the economic pressures become so intense that the pendulum has swung too far away from the heart of what we do in health care? And as physician leaders, what small changes can you make to bring increased attention to the patient and caregiver experience?

One option may be to purchase this book for your physician leadership team, residency faculty, and/or a group of residents – asking them to read it and come together in small groups to share insights and brainstorm ideas. It’s at least a start.

Per Dr. Fanale, “While we need physicians to push for the best possible patient care clinically, we have to understand that when the shoe is on the other foot, the whole perspective changes. Communication and empathy for both patient, caregiver, and family are of the utmost importance.”