Exploring and overcoming barriers to clinical empathic communication

Abstract

It is widely accepted that effective clinical communication enhances the physician–patient relationship. Studies and clinicians agree almost universally that improved communication increases both physician and patient satisfaction, decreases malpractice risk, and improves diagnostic accuracy. Empathic communication is a key element in most, if not all, communication models. Despite this, physicians often have misconceptions and misgivings related to the use of clinical empathy. These barriers can lead to reluctance and avoidance in the use of this otherwise effective and powerful communication skill. Physicians most often cite barriers in four primary categories: (1) the perception of not enough time in the clinical encounter; (2) the desire (either consciously or unconsciously) to avoid a flood of strong feelings, often described as opening 'Pandora's Box'. This worry arises especially when emotions such as anger or sadness are involved; (3) the fear of empathy being emotionally exhausting and leading to burnout, and (4) the lack of training in empathic communication as it relates to awareness of opportunity and appropriate response. In this paper, we explore these barriers to empathic communication as they have been identified in the medical literature and reported to us informally during our interactive clinician–patient communication workshops. We provide language for physicians to use to improve familiarity and comfort with this communication skill.