Empathy in your diabetes care: a luxury or a necessity?

Daniel Sher dives into the science of empathy to show why empathy is a healthcare necessity, rather than a luxury.

As people with diabetes, most of us have experienced leaving the doctor feeling unheard, despondent, fearful, anxious or misunderstood. If we’re lucky enough to have a doctor who really cares, though, we may leave the consult feeling hopeful, heard, supported and considered. Through empathy, our doctors are setting us up for success in more ways than one.

What is empathy?

It is the ability to put yourself in the shoes of another and see things from their perspective. Ultimately, empathy involves a healthy, authentic connection between two people. Empathy comes easier to some than others, but it is a skill which, ultimately, can be learned and refined.

While some think of empathy as a vague and ‘fluffy’ concept, science has explored this ability fairly rigorously. We know, for example, that people who lack empathy tend to have reduced functioning in a specific part of the brain (the right supramarginal gyrus) which helps us to gauge the emotional state of others. We also know that empathy has real and significant implications for a person’s health, as we’ll discuss in more detail below. But first:

What does a doctor’s empathy look like?

There’s no doubt that some doctors’ empathy skills are stronger than others. The following are possible indicators that your healthcare professional is doing a good job on the empathy front.

• You’re engaged in collaborative decision making about your treatment, rather than being told what to do.
• You feel heard during the session.
• You’re left feeling genuinely cared for, rather than told-off.
• Your doctor explores the reasons for your difficulties, rather than simply pointing out where you’re going wrong.
• Your doctor asks open-ended questions and really listens when you respond.
• You feel that your concerns have been acknowledged, rather than brushed aside.

Barriers 

What stops a doctor (or any other person) from practicing empathy? If a person is anxious, sad, exhausted or over-stressed, this can stop one from being able to access the parts of the brain that help us to empathise with others.

For those who know how gruelling medical school can be, therefore, it may come as no surprise that medical training is known to lower empathy. It’s important for us to be empathic with our doctors in this regard. However, it’s also important that our doctors take responsibility for managing their workload and mental health properly, so that they can continue to fulfil the Hippocratic Oath by providing empathic care.

Keep in mind that in South Africa, state healthcare services are often under a great degree of pressure. Doctors with huge caseloads and ongoing exposure to trauma are less likely to be able to muster empathy than those who are not exposed to such conditions.

Does empathy really matter?

In short, yes. The science quite clearly tells us that empathy matters when it comes to diabetes care. More specifically, the research shows that empathy is more than just a vague and fuzzy feeling that is perhaps nice to have. Rather, empathy from your doctor may have a direct impact on your health. Let’s look at what some of the research has shown:

• A study found that patients who have empathic physicians are more likely to follow treatment recommendations, including glucose testing, diet, exercise and medications.
• The same study also found that patients who have empathic doctors tend to have a higher quality of life.
• In this 2004 paper, it was shown that empathic doctors are better able to help their patients stick to proper self-care routines. Interestingly, the research showed that empathy ratings were, in fact, more important than the doctors’ medical expertise.
• These researchers found that patients with empathic doctors tend to have lower HbA1C levels.
• Amazingly, this 2019 study found that patients who have very empathic doctors are up to 50% less likely to die of heart-related issues.
• Finally, this study found that empathic doctors help their patients to avoid admissions for diabetic ketoacidosis.

So, luxury or necessity? 

For many of us, empathy is little more than an afterthought. We feel lucky if our doctor leaves us feeling heard; but we don’t really feel that we have a right to expect empathy from our healthcare team. The science, however, suggests that empathy is far more than just a luxury. Rather, having an empathic doctor is a necessity and something to which we, as diabetic patients, have a right.

References

1. Dambha-Miller, H., Feldman, A. L., Kinmonth, A. L., & Griffin, S. J. (2019). Association between primary care practitioner empathy and risk of cardiovascular events and all-cause mortality among patients with type 2 diabetes: A population-based prospective cohort study. The Annals of Family Medicine, 17(4), 311-318. 
2. Del Canale, S., Louis, D. Z., Maio, V., Wang, X., Rossi, G., Hojat, M., & Gonnella, J. S. (2012). The relationship between physician empathy and disease complications: an empirical study of primary care physicians and their diabetic patients in Parma, Italy. Academic medicine, 87(9), 1243-1249.
3. Eltaher, S. M., Rashid, M. A., Mahdy, A. W., & Lotfy, A. M. M. (2020). Physicians’ Empathy and Its Effect on Adherence to Treatment of Diabetic Patients in Al-Qassim Region, Saudi Arabia. Annals of Tropical Medicine and Health, 23, 231-638.
4. Hojat, M., Louis, D. Z., Markham, F. W., Wender, R., Rabinowitz, C., & Gonnella, J. S. (2011). Physicians’ empathy and clinical outcomes for diabetic patients. Academic Medicine, 86(3), 359-364.
5. Kim, S. S., Kaplowitz, S., & Johnston, M. V. (2004). The Effects of Physician Empathy on Patient Satisfaction and Compliance. Evaluation & the Health Professions, 27(3), 237–251

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