QWhat is Empathic Failure and How Can I Avoid It?

Empathy is a critical component of bedside manner and the physician-patient relationship. Empathic failure is when a physician fails to connect with the patient’s perception of their issue, no matter how small or insignificant it may seem.

An example of empathic failure is the following scenario, where a 15-year-old female presents to the office with a few small pimples on her forehead.

Patient: Hi Doctor, my acne is really bothering me. It makes me very self-conscious.

Doctor: What do you mean? I only see a few bumps. Your acne is very mild.

This patient may storm out of the office in anger, thinking to themselves… “this doctor doesn’t get me and is not listening to me”. I am sure we can all relate to the above scenario when the patient in the exam room next door has severe nodulocystic acne and needs to start isotretinoin immediately.

To help avoid empathic failure in a busy practice, I try to avoid saying things like “this isn’t so bad”, “this is a minor problem” or “why are you worrying so much about this issue?”. Obviously, there are scenarios when phrases like this are appropriate but its best to be very cognizant when using them, especially with new patients.

As a general rule of thumb, when patients present with a problem, I like to say something like “I’m sure this is really bothering you”. This allows the patient to agree with you or disagree with you. If the patient agrees then no harm has been done. If the patient disagrees and states this issue is not really bothering them at all, then you can tell the patient you are glad to hear they are not very bothered and you are happy to help them anyway.

References:

1. Dermatology World March 2018: What You Say Vs. What Patients Hear. https://digitaleditions.walsworth.comhttps://digitaleditions.walsworth.com/article/What+You+Say+Vs.+What+Patients+Hear/3010071/475507/article.html