Abstract
Background: Medical practitioners such as physicians are continuously exposed to the suffering and the distress of patients. Understanding the way pain perception relates to empathetic dispositions and professional quality of life can contribute to the development of strategies aimed at protecting health professionals from burnout and compassion fatigue. In the present study we investigate the way individual dispositions relate to behavioral measures of pain sensitivity, empathy, and professional quality of life.Methods: A secure Web-based series of self-report measures and a behavioral task were administered to 1,199 board-certified physicians. Additionally, surveys were used to obtain measures of demographic and professional background; dispositional empathy (empathic concern, personal distress, and perspective taking); positive (compassion satisfaction) and negative (burnout and secondary traumatic stress) aspects of their professional life. In the behavioral task, participants were asked to watch a series of video clips of patients experiencing different levels of pain and provide ratings of pain intensity and induced personal distress.Results: Perceived pain intensity was significantly lower among more experienced physicians but similar across specialty fields with varying demands of emotional stress. Watching videos of patients in pain, however, elicited more personal distress among physicians in highly demanding medical fields, despite comparable empathy dispositions with other fields. The pain of male patients was perceived as less intense than the pain of female patients, and this effect was more marked for female physicians. The effect of dispositional empathy on pain perception and induced personal distress was different for each sub-component, with perspective taking and empathic concern (EC) being predictive of the behavioral outcomes. Physicians who experience both compassion satisfaction and fatigue perceive more pain and suffer more personal distress from it than those who only suffer the negative aspects of professional quality of life.Conclusions: Professional experience seems to desensitize physicians to the pain of others without necessarily helping them down-regulate their own personal distress. Pain perception is also related with specific aspects of empathy and varies depending on context, as is the case with the gender of their patients. Minimum levels of empathy appear necessary to benefit from the positive aspects of professional quality of life in medicine.
Highlights
Clinical empathy is an essential element of quality care, associated with improved patient satisfaction, increased adherence to treatment, and fewer malpractice complaints (Burns and NolenHoeksema, 1992; Rakel et al, 2009, 2011; Hojat et al, 2011; Del Canale et al, 2012) as well as increased physician health, well-being, and professional satisfaction (Mercer and Reynolds, 2002; Benbassat and Baumal, 2004)
The effect of dispositional empathy on pain perception and induced personal distress was different for each sub-component, with perspective taking and empathic concern (EC) being predictive of the behavioral outcomes
Physicians who experience both compassion satisfaction and fatigue perceive more pain and suffer more personal distress from it than those who only suffer the negative aspects of professional quality of life
Summary
Clinical empathy is an essential element of quality care, associated with improved patient satisfaction, increased adherence to treatment, and fewer malpractice complaints (Burns and NolenHoeksema, 1992; Rakel et al, 2009, 2011; Hojat et al, 2011; Del Canale et al, 2012) as well as increased physician health, well-being, and professional satisfaction (Mercer and Reynolds, 2002; Benbassat and Baumal, 2004). The vast majority of doctors have the capacity for empathy (Handford et al, 2013) Particular skills such as attention, self-regulation, and emotional awareness are needed to reliably respond empathically to distressed patients while making difficult decisions and performing potentially highrisk, high-demand interventions. Maintaining person-oriented connections during such high stress conditions requires a great deal of attention and self-regulation, which taxes a limited supply of cognitive and emotional resources (Feighny et al, 1995; Haque and Waytz, 2012) Medical practitioners such as physicians are continuously exposed to the suffering and the distress of patients. In the present study we investigate the way individual dispositions relate to behavioral measures of pain sensitivity, empathy, and professional quality of life
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