Although clinical experience develops many skills, physicians benefit from external input for improving communication skills.1,2 Physicians can use the following techniques and training resources to improve their communication with patients and demonstrate empathy.
Open-Ended Phrases for Reflection Back
Open-ended phrases can be used to reflect perceptions of patient feelings and values back to the patient:3,4
- “Sounds like you are...”
- “Let me see if I’ve gotten this right ...”
- “What you’re saying is ...”
- “If I understand you correctly, you ...”
- “You feel ...”
- “I want to make sure I understand what you’ve said ...”
- “I imagine that must be ...”
- “I can understand that must make you feel ...”
Using phrases like these can increase patients’ perceptions of physician empathy.
The BATHE Technique
The BATHE technique can help physicians discover emotional issues in a time-sensitive manner.5
| Example Question | ||
| B | Background | “What’s going on in your life?” |
| A | Affect | “How do you feel about that?” |
| T |
Troubles |
“What troubles you most about this?” |
| H | Handling | “How are you handling this?” |
| E | Empathy | “That must be difficult for you.” |
Training Resources
Empathy training curricula and methods differ, but most focus on physician self-monitoring for improving listening skills, reading facial expressions and body language and controlling emotional entanglement. Some programs use actors as simulated patients and provide feedback to individual doctors, while others provide online learning courses.6
The following is a selection of tools and programs for physicians who want to work on their empathy skills.
The VitalTalk website offers free lessons and training videos on topics including establishing rapport with patients, tracking and responding to emotions and diffusing conflict.
The Art of Medicine: A Physician-Patient Communication Conference
CIR Policy and Education Initiative. November 2011.
Drs. August Fortin and Sheira Schlair provide details about empathic communication during this free 36-minute presentation.
Empathetics: Neuroscience of Emotions
Empathetics
This course is a three-module series that teaches physicians how to detect and manage the emotional states of patients and how to respond with empathy and compassion and emotional self-management skills that are designed to be easily incorporated into a physician’s daily practice.
Yes Empathy Can Be Taught!
The Schwartz Center for Compassionate Healthcare
This is a free hour-long webinar by Helen Riess, MD, the co-founder, chief scientific officer and chairman of Empathetics.
Narrative Medicine Workshops
Columbia University
Narrative medicine workshops emphasize the importance of understanding patients’ life stories in providing compassionate care. The training can help physicians with empathic interviewing, reflective practice, narrative ethics, self-awareness, and creating and sustaining healing intersubjective contact with patients and colleagues.
References
1. Skinner CS, Pollak KI, Farrell D, Olsen MK, Jeffreys AS, Tulsky JA. “Use of and Reactions to a Tailored CD-ROM Designed to Enhance Oncologist-Patient Communication: The SCOPE Trial Intervention.” Patient Educ Couns. 2009; 77:90-6. (accessed 9/24/2018)
2. Tulsky JA, et al. “Enhancing Communication Between Oncologists and Patients with a Computer-Based Training Program: A Randomized Trial.” Ann Intern Med. 2011;155(9):593-601. (accessed 9/24/2018)
3. Hardee J. “An Overview of Empathy.” The Permanente Journal. Fall 2003:7(4):51-54. (accessed 9/24/2018)
4. Lussier M, Richard C. “Reflecting Back: Empathic Process.” Canadian Family Physician. 2007;53(5): 827-828. (accessed 9/24/2018)
5. Adopted from: Stuart MR, Lieberman JA. The Fifteen Minute Hour: Applied Psychotherapy for the Primary Care Physician, 2nd ed. Westport, Conn: Praeger, 1993. Cited in Leiblum SR, Schnall E, Seehuus M, DeMaria A. “To BATHE or Not to BATHE: Patient Satisfaction with Visits to Their Family Physician.” Fam Med. 2008 Jun;40(6):407-11. (accessed 9/24/2018)
6. Boodman S. “How to Teach Doctors Empathy.” The Atlantic. March 15, 2015. (accessed 9/24/2018)
