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Thursday, October 27, 2005 

Sympathy & Compassion in Medicine

"...Sympathy and tact will often prove a greater benefit to the sick
than will the most skillful treatment given in a cold, indifferent way"

It's easy to forget how to sympathize, empathize, or be compassionate when you are in the medical field. As a doctor, I see pain, suffering, & dying all the time. Technology, by lessening the interaction between the doctor and his patient adds to the loss of sympathy. I have seen some doctors berate patients who were already in pain. Some even blamed the patients for their illness - which even if true plays no role in the treatment of the patients.

In 2001, a systematic review was conducted to determine if doctor-patient relationships have a therapeutic effect, independent of any drug treatment.

There is much inconsistency regarding emotional and cognitive care, although one relatively consistent finding is that physicians who adopt a warm, friendly, and reassuring manner are more effective than those who keep consultations formal and do not offer reassurance. [Influence of context effects on health outcomes: a systematic review]

An 2003 Editorial in the Medical Journal of Australia, "Can compassion survive the 21st century?" asked the question: "Is compassion in its death throes two millennia after one man in Jerusalem advocated loving others as oneself, and another in Mecca described “a person’s true wealth [as] the good he or she does in the world”?" and noted that the answer is happily, "No", since there are many doctors still motivated by compassion.

I have been exposed to both government and private hospitals here in the Philippines and I have observed that genuine compassion is more often practiced by those working in government hospitals where most of the patients are poor and cannot afford proper health care. Unfortunately, it is also where I observed poor treatment of patients. Apparently, poor working conditions bring out the best and worst in doctors.

In Medical school, the bioethics class constantly reminded me to remember that the patient is a human being, not just a bed number or a case study. It's not an easy thing to remember when you have only 1 hour to finish your morning rounds of 20+ patients.

"...role models are integral to medical training, and medical students and young doctors value attributes such as compassion in their role models, as eminent neurologist Lance attests. Yet good role models are not plentiful in our hospitals… Medical schools must be responsive to, and proactive about, societal needs. Our initial and ongoing education should also seek to actively instil a recognition of the social determinants of health, and the place of humane values and ethics." [Can compassion survive the 21st century?]

A medical student has this to say in his post:

I firmly believe that all doctors-to-be go into medical school with a big heart and that “I want to help people” mentality, but then reality shoves her acne-riddled, bloated face in their way and they slowly shift from spending as much time as they can knowing their patients to making sure they have acquired the maximum amount of information in the smallest amount of time that will appease their superiors. Why? Because there are 60 patients in the waiting room demanding to be seen right now, and one of them may or may not be packing a rifle. Of course, every patient thinks he or she is the most important patient there, and who is anyone to say they are wrong…I guess what I’m trying to say is, I have yet to see a doctor not busting his or her ass day in and day out, but given the medical establishment as it currently stands, it is really difficult to make it through the day without detaching yourself from the patients and still having enough left over to come home and be at least moderately functional. [Ask The Fake Doctor 3 - Ah Yes, Medical School]
I understand his sentiments. They say that "knowing is half the battle." So I'm left with the other half - showing compassion to my patients

"If you want others to be happy, practise compassion.
If you want to be happy, practise compassion." [The Dalai Lama]

great new look!

Thanks for this post. I had a horrible hospital stay and almost died due to medical negligence. It's nice to know that there are some doctors who care.

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