Surgical Oncologist Discusses Empathy as Critical Ingredient of Good Medical Care Interview with:

Dr. Dmitri Alden MD, FACS Surgical Oncologist, specializes in liver cancer, bile duct cancer, metastatic ovarian cancer and pancreatic cancer at Lenox Hill Hospital, NY Dr. Alden is an advocate of the role of empathy in medicine

Dr. Dmitri Alden

Dr. Dmitri Alden MD, FACS
Surgical Oncologist, specializes in liver cancer, bile duct cancer, metastatic ovarian cancer and pancreatic cancer at Lenox Hill Hospital, NY

Dr. Alden is an advocate of the role of empathy in medicine and discusses his passion for compassionate care in this interview.
Please see his bio and website at Why do you feel that empathy is a vital part of treating a patient?

Response: Over the last decade many physicians, patients and other professionals began to recognize that medical care is much more than treatment with medications or an act of surgery. Healing involves pain and suffering and dealing with psychological issues connected to the stress of being taken out of one’s normal life routine. Pain is now considered a “vital sign” and only recently it became mandatory to address it properly and document it in a medical record. Empathy in my opinion is a “vital sign” of any relationship that forms between a patient and a medical professional. When expressed genuinely, it makes a tremendous impact on patient’s overall experience and recovery. How do you define empathy in regards to medical treatment?

Response: Empathy is understanding and true genuine caring. Patients and doctors create a unique and very personal relationship built on trust and “chemistry”. The doctor’s ability to express empathy, step in the patient’s shoes, get to know their life, loves, personal problems and to structure care around this unique individual enhances the patient’s belief in the route of treatment chosen and the doctor’s ability to provide a cure. Do you feel that the medical system doesn’t emphasize empathy enough?

Response: Doctors are trained without an emphasis on empathy. They focus on acquiring immense amounts of information that need to be learned during medical school and residency. Emotions are currently left to the side in order to succeed. The end product is often a machine that knows what to do in any medical situation but has difficulty to connect on an emotional level. I feel that empathy is also a very important step towards achieving successful outcomes because a patient will feel more invested in following the doctor’s advice if he feels there is compassion and understanding. Is there a disconnect between the doctor and the patient without empathy?

Response: Without empathy medicine can become robotic. It is easy to envision the automation process of diagnostics and treatment delivery. A robot can dispense antibiotics based on another robot’s strep throat culture, but someone must provide comfort and reassurance that the patient will still be able to sing at the school play next week. That can only come from a human touch. How does empathy help families of patients?

Response: Doctors must understand that addressing the family’s emotional suffering and grief is an integral part of treating the patient. I always feel that during the journey of patient treatment, the doctor becomes part of the family. By acting as a member of the family the doctor can lead and provide comfort and help everyone believe in and work together towards a good outcome. How can we change the doctor-patient conversation in this area?

Response: We often talk about steps we need to take to help soldiers with PTSD. Not all returning soldiers have the same problem. Patients are people, and they often have a very different perception of the same event. Empathy first and foremost helps to identify psychological challenges that patients are experiencing. It helps patients to express and doctors and families to understand the deep emotional level of suffering. Connecting on an emotional level and addressing stress is very similar to dealing with pain that used to be ignored in the past.

First, doctors must understand that a condition or an injury puts the patient in a vulnerable state. By descending down the “white coat ladder” and showing a human side and your own vulnerability one will make a connection much easier. How can we train doctors in empathy?

Response: Doctors and patients are people and they are all different. Perception may be far from reality but that is what drives relationships between a physician and a patient. Proper training must start early in medical school where subjects such as human perception, cultural differences and language barrier issues must be addressed as issues that students need to think about. Training sessions with actors could facilitate building necessary skills. How do you yourself maintain hope and empathy in the face of death and dying on a daily basis?

Response: Fortunately, we have many more good stories than tragedies. I always try to stay human and vulnerable with my patients. I share some of the stories of the past, my successes and my failures, my personal experiences as a doctor, as a patient and as a family member caring for my own sick and dying parents and relatives. I feel that’s part of the human touch that often helps me to establish good rapport. The key is to tell the truth and stay genuine. How do you save some of yourself for your family and loved ones?

Response: It is the absolute hardest part. It is impossible to put the tools down, wash your hands and close the shop until the next morning. One cannot forget about all the human stories and tragedies when leaving work. Unfortunately, you carry it with you. I am trying to learn how to compartmentalize and control my thoughts. What do you tell your students and residents about the caring for patients during their difficult journey through cancer?

Response: Cancer is the most devastating diagnosis one can receive. Doctors must mentally teach themselves to step into patients’ shoes and ask themselves a question “What if it was me?” Doctors often say they’d refuse surgery or chemotherapy in the case of cancer diagnosis.

However, statistics and my personal experience show quite the opposite response once it becomes reality. When doctors become patients they experience exactly the same emotional stages and look for the same feelings of empathy. Explaining that to students and residents helps them to understand psychological and emotional challenges cancer patients are facing. Doctors must understand they are human and not special. I ask my students to be generous with their time, get to know the patient as a human being, be vulnerable and open about yourself. That’s how you make friends, build relationship and help others.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on November 22, 2016 by Marie Benz MD FAAD